Colonic Diseases, Educational Problems, Nurse-Patient Relations
Conditions
Keywords
Colonoscopy, Quality, Telephone intervention
Brief summary
This study assesses what impact has on colonoscopy quality the implementation of a telephone educational intervention carried out individually on the patient in the days before the test. Half of the study patients will receive the educational intervention and the other half will not.
Detailed description
A high-quality colonoscopy is an examination in with patients receive an indicated procedure, correct and relevant diagnoses are recognized or excluded, any therapy provided is appropriate, and all steps that minimize risk have been taken. But quality also refers to pre-procedure and post-procedure quality issues such as information, booking, choice, privacy, dignity, aftercare and satisfaction of patients. All those issues can negatively affect the willingness of patients to perform the test and the possibility of preparing adequately. And what is more, it can diminish the quality of the own exploration, the satisfaction of the patients and their adherence to programs of endoscopic follow-up. An action on these colonoscopy non-technical issues with a telephone educational intervention performed by the gastrointestinal endoscopy nurse can positively improve all (pre, intra and post-procedure) colonoscopy quality indicators.
Interventions
OTHEREducational telephone call
Explanation of the importance of making the test. Guidelines for the usual medication of the patient. Definition of fasting, explanation of colon cleansing adjusted to the presence of predictors of poor basic preparation. Explanation of the endoscopic procedure with the elimination of erroneous concepts of the patient with respect to the procedure. Explanation of norms of action subsequent to the endoscopy. Management of scheduling, destined to improve the adherence of the patient for the test.
Sponsors
Parc de Salut Mar
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Investigator)
Masking description
The endoscope that performs the colonoscopy and the person in charge of collecting the data of colonoscopy complications and the overall satisfaction of the procedure will be blind to the patient group.
Intervention model description
Reference population: all outpatient referred for the realization of a colonoscopy, regardless of the requesting Service. Two groups. One of them will receive an complete educational telephone call 7 days before de procedure in addition to the information received from the primary care center on the day of the request for the test. The inclusion in each one of the groups will be done through a randomization sheet. The intervention includes educational aspects: Explanation of the importance of making the test. Guidelines for the usual medication of the patient. Definition of fasting, explanation of colon cleansing adjusted to the presence of predictors of poor basic preparation. Explanation of the endoscopic procedure with the elimination of erroneous concepts of the patient with respect to the procedure. Explanation of norms of action subsequent to the endoscopy. Management of scheduling, destined to improve the adherence of the patient for the test.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All outpatient referred from the Primary Care Centers to perform a colonoscopy in our Digestive Endoscopy Unit, regardless of the applicant's Service.
Exclusion criteria
* Hospital patients, patients who refuse inclusion in the study, patients included in another study, impossibility of carrying out the educational intervention and patients who are unable to obtain informed consent will be excluded from the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Colonoscopy non-adherence rate | At the moment of colonoscopy | Ratio of patients do not attend the test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Anesthetist rescheduling rate | At the moment of colonoscopy | Ratio of patients attend the colonoscopy with American Society of Anesthesiologists (ASA) III / IV classification so they need rescheduling of the test under anesthesia |
| Bowel preparation rescheduling rate | At the moment of colonoscopy | Ratio of patients attend the colonoscopy with inadequate Boston Bowel Preparation Scale (at least one of the colon segments with less than 2 points) so they need rescheduling of the test |
| Adenoma detection rate | At the moment of colonoscopy | Ratio of patients with at least one adenoma in the colon |
| Antiplatelet / anticoagulant rescheduling rate | At the moment of colonoscopy | Ratio of patients attend the colonoscopy with poor adjustment of antiplatelet / anticoagulant medication so they need rescheduling of the test |
| Satisfaction of the endoscopic procedure | 30 days after colonoscopy | Measurement of the overall satisfaction of the colonoscopy with a questionnaire validated by the American Society for Gastrointestinal Endoscopy (ASGE) |
| Complications related to colonoscopy | 30 days after colonoscopy | Telephone interview. The patient will be asked about the appearance of perforation, hemorrhage and abdominal symptoms related to the test |
| Non-adequation colonoscopy cost of patient preparation for colonoscopy | From date of randomization until 30 days before colonoscopy | Cost derived from non-adequation |
| Cecal intubation rate | At the moment of colonoscopy | Ratio of successful complete colonoscopies (cecal intubation or in case of previous surgery, ileocolic anastomosis) |
Countries
Spain
Outcome results
None listed