Introduction This was a descriptive study on how patient’s pre-procedure anxiety and understanding affect experience and post procedural satisfaction of colonoscopy. Colorectal cancer is the fourth leading cancer in the UK in terms of incidence accounting for 33,765 new cases in 2013. Colonoscopy plays a major role in the prevention and management of colorectal cancer. However, patient uptake of colonoscopy has been shown to be adversely affected by anxiety and lack of knowledge. Post procedure satisfaction which can affect compliance to treatment, has been shown to be affected adversely by procedure discomfort and long wait times.The bowel cancer-screening programme (BCSP) aims to detect bowel cancer at an early stage where treatment is most likely to be effective. Patients are offered a colonoscopy after positive faecal occult blood testing. Prior to the procedure they are seen by a specialist nurse, and during a lengthy consultation the risks and benefits of the procedure are explained.Symptomatic patients referred from clinic will not receive such an in depth discussion regarding the procedure, although this may vary from physician to physician.Patients undergoing surveillance colonoscopy (previous polyps, family history, inflammatory bowel disease) may undergo no further discussion prior to their repeat procedure.
Methods Over a month period (June 2015), patients undergoing colonoscopy at the Endoscopy Unit of St. George’s Hospital were identified. They were asked to complete a questionnaire before and after their procedure.
Questions were asked to gather data on: patient demographics, purpose of having colonoscopy, patient’s awareness of the benefits and risks of the procedure, level of anxiety and level of satisfaction following their colonoscopy.
Results 133 patients participated in the study. 71 patients were male. The mean age was 62.3 years (range of 22–83 years). 43 patients were invited as part of the BCSP, 49 were symptomatic from clinic and 41 were undergoing surveillance. Patients invited through the BCSP had the highest rate of awareness of the benefits at 76.7%. Symptomatic patients from clinic had the lowest rate of awareness of benefit at 53.1%. In contrast, the symptomatic patients had the highest understanding of risks at 67.3% compared with the lowest rate of 60.5% in the BCSP group. 96% of the referral group reported a low level of anxiety compared with 88.4% of the BCSP group. 73.1% of patients in the surveillance group reported no or mild discomfort. 68% of the BCS group reported no or mild discomfort BCS group with 68.9%. The referral group recorded the highest level of moderate to severe discomfort at 36.8% There was a high level of procedure satisfaction with 92% recorded in the surveillance group, 86% in the BCSP group and 94% in the referred group. 85% of the surveillance and 79% of the BCSP group were happy to have the procedure with a slightly lower rate of 75% of the referral group. 8.2% of the referral group would prefer to avoid a repeat procedure compared with whereas the rate were 7.3% of the surveillance group and 4.6% of the BCSP group.
Conclusion Colonoscopy remains the most accurate tool in diagnosing and managing bowel disease. The BCSP can help to significantly reduce morbidity and mortality from CRC. However, patient uptake of colonoscopy can be adversely affected for a number of reasons. Our study emphasised the importance of explaining the benefits and risks of colonoscopy, to reduce pre-procedural anxiety in an attempt to improve patient satisfaction and further compliance.
Disclosure of Interest None Declared
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