Introduction Barrett’s oesophagus (BE) is the only identifiable pre-cursor condition for oesophageal adenocarcinoma. Endoscopic surveillance is performed in BE to detect dysplasia as it likely to be amenable to curative therapy.
There is data to suggest that a diagnosis of BE has a negative impact on the quality of life of patients. To our knowledge, no guidance exists on the counselling of patients entered into endoscopic surveillance for BE.
The aim of this study was to check patient understanding of their diagnosis of BE and associated anxiety levels at a district general hospital.
Method An in-house database was used to identify patients with BE over a 10 year period (2006–17). A simple, 14-point based questionnaire was devised and answers obtained via a telephone consultation (Table 1).
Results 163 patients with BE were identified. In total, 104 patients (70 male, 34 female) were recruited (13 deceased, 38 did not answer, 8 declined). 2 patients had previously undergone therapy for BE (1 RFA, 1 fundoplication).
Results are displayed in Table 1. Less than a third of patients remembered meeting a clinician to discuss their diagnosis and the rationale for follow-up. Consequently, only 41% of patients understood their diagnosis and 44% the rationale for surveillance. Although almost all patients (92%) were on a regular proton pump inhibitor, less than half (48%) understood why. Only 11% of patients were aware of the overall cancer progression risk and even fewer (7%) of the treatment options that are currently available.
Interestingly, half of all patients admitted feeling anxious about their diagnosis with the majority (82%) admitting that further counselling would benefit in this regard.
Conclusion We have demonstrated that patients with BE have a relatively poor understanding of their diagnosis and the treatment options that are available to them. Further efforts need to be made to address this and help empower a group of patients who are understandably anxious about their diagnosis.
Disclosure of Interest None Declared
- Barretts Oesophagus
- service development
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