Combined written and oral information prior to gastrointestinal endoscopy compared with oral information alone: a randomized trial

Christian Felley¹^,2 , Thomas V Perneger³ , Isabelle Goulet² , Catherine Rouillard¹ , Nadereh Azar-Pey¹ , Gian Dorta² , Antoine Hadengue¹ and Jean-Louis Frossard¹

¹Division of Gastroenterology and Hepatology, University Hospitals, and University of Geneva, Geneva, Switzerland

²Division of Gastroenterology and Hepatology, University Hospital, and University of Lausanne, Lausanne, Switzerland

³Clinical Epidemiology Service, University Hospitals, Geneva, Switzerland

author email corresponding author email

BMC Gastroenterology 2008, 8:22doi:10.1186/1471-230X-8-22


Published:	3 June 2008

Abstract

Background

Little is known about how to most effectively deliver relevant information to patients scheduled for endoscopy.

Methods

To assess the effects of combined written and oral information, compared with oral information alone on the quality of information before endoscopy and the level of anxiety. We designed a prospective study in two Swiss teaching hospitals which enrolled consecutive patients scheduled for endoscopy over a three-month period. Patients were randomized either to receiving, along with the appointment notice, an explanatory leaflet about the upcoming examination, or to oral information delivered by each patient's doctor. Evaluation of quality of information was rated on scales between 0 (none received) and 5 (excellent). The analysis of outcome variables was performed on the basis of intention to treat-analysis. Multivariate analysis of predictors of information scores was performed by linear regression analysis.

Results

Of 718 eligible patients 577 (80%) returned their questionnaire. Patients who received written leaflets (N = 278) rated the quality of information they received higher than those informed verbally (N = 299), for all 8 quality-of-information items. Differences were significant regarding information about the risks of the procedure (3.24 versus 2.26, p < 0.001), how to prepare for the procedure (3.56 versus 3.23, p = 0.036), what to expect after the procedure (2.99 versus 2.59, p < 0.001), and the 8 quality-of-information items (3.35 versus 3.02, p = 0.002). The two groups reported similar levels of anxiety before procedure (p = 0.66), pain during procedure (p = 0.20), tolerability throughout the procedure (p = 0.76), problems after the procedure (p = 0.22), and overall rating of the procedure between poor and excellent (p = 0.82).

Conclusion

Written information led to more favourable assessments of the quality of information and had no impact on patient anxiety nor on the overall assessment of the endoscopy. Because structured and comprehensive written information is perceived as beneficial by patients, gastroenterologists should clearly explain to their patients the risks, benefits and alternatives of endoscopic procedures. Trial registration: Current Controlled trial number: ISRCTN34382782.