Verbal consent decreases patient anxiety about colonoscopy
The consent process may help reduce anxiety of patients undergoing colonoscopy, according to a recent study. However, written or video educational adjuncts provided on the day of colonoscopy appear to have no effect on patient perceptions when used in conjunction with a high-quality verbal consent.
The authors assessed a multifaceted intervention to improve the consent process. Gastroenterologists at a tertiary centre were educated on the recommended components of informed consent. Three cohorts of patients undergoing colonoscopy were then surveyed before and after consent.
The effect of optimized verbal consent alone was evaluated in one cohort, whereas the effects of the addition of either a handout or a video describing colonoscopy and its risks were assessed in the second and third groups.
The primary endpoints included changes between pre- and postconsent survey responses regarding confidence in understanding the procedure’s purpose, likelihood of adverse events and anxiety levels.
A total of 240 patients were included in the study, with 79–81 participants per group. No significant differences were observed among the groups’ survey responses.
Fewer patients in the handout and video groups increased their perceived risk of adverse events following consent as compared with those who received verbal consent alone. However, this difference was not statistically significant (p=0.08).
When all groups were examined together, a significant change in anxiety levels were seen after consent (p=0.003), with 31 percent of patients experiencing reductions, 8 percent having increases, and 62 percent showing no change.
“Informed consent is a vital preprocedural step for endoscopy, but there are substantial variations in its delivery,” the authors said.