Improving the Consent Process with an Informed Consent Video Prior to Outpatient Colonoscopy

Improving the Consent Process with an Informed Consent Video Prior to Outpatient Colonoscopy
Original Research
Emily W. Lopes, Leo Boneschansker, Jacqueline N. Chu, James M. Richter, Amiko M. Uchida, Paul Lochhead
Gastro Hep Advances, 28 July 2023
Abstract
Background & Goals
Informed consent should allow patients appropriate time and conditions to make decisions about their care. However, consent is often obtained immediately prior to colonoscopy. We conducted a quality improvement study to assess how a pre-procedure consent video two days prior to outpatient colonoscopy impacts patient satisfaction.
Study
Patients undergoing outpatient colonoscopy at a large academic medical center opted-in to a text-messaging platform for procedural information. Our intervention was an informed consent video two days before colonoscopy. Our primary outcome was a composite patient satisfaction score. Pre- and post-intervention scores were compared using ordinal or multinomial logistic models to calculate odds ratios (OR) or relative risk ratios (RRR) and 95% confidence intervals (CI), adjusting for age and sex.
Results
1,109 and 1,452 patients completed ≥1 survey question in the pre- and post-intervention phases, respectively. Overall patient satisfaction did not differ between groups [OR for a 1-point increment in satisfaction score between post- vs. pre-intervention groups=1.05; 95% CI: 0.90-1.22; p=0.51]. Compared to pre-intervention, post-intervention respondents were more likely to report higher satisfaction with time available to talk with their physician (OR of a 1-point increase in individual question response=1.29; 95% CI: 1.09-1.54; p=0.004). Compared to pre-intervention, more physicians in the post-intervention phase rated satisfaction with consent process efficiency as “very satisfied” or “satisfied” (p<0.001).
Conclusion
An informed consent video prior to colonoscopy resulted in similar overall patient satisfaction. However, post-intervention, patients were more likely to report sufficient time to talk with their physician, and physicians reported higher satisfaction with consent efficiency.