Dartmouth study cites positive impact of interactive, Web-based patient engagement program

Dartmouth-Hitchcock gastroenterologist Corey Siegel, MD, MS, is no stranger to patients having colonoscopy jitters.’ He knows that fear of the unknown holds a lot of patients back:’ ‘ 28 percent of those over age 50 have not been screened for colon cancer, largely due to fears about the preparation and the procedure itself.’ Siegel, along with Geisel School of Medicine graduate Jonathan Zipursky, now at the University of Toronto, Geisel medical student Helen Ma, and Gastroenterology fellow Siddhartha Parker, MD, posed the question:’ Is there a way to reduce anxiety about the procedure for first-time colonoscopy patients?’ Now, Siegel and his team have found a way to reduce patient anxiety and improve education about what to expect before, during, and after a colonoscopy.
A research team headed by’ Siegel conducted a randomized controlled study investigating the impact of an interactive web-based multi-media program on patient anxiety, perception, and knowledge of colonoscopy. Fifty-one patients were given Dartmouth-Hitchcock’s standard printed pre-procedure colonoscopy packet, while 52 patients watched the web-based colonoscopy program created by Emmi Solutions, in addition to receiving the same packet.’ The findings of the study were presented by Dr. Siddhartha Parker at the 2013 American College of Gastroenterology Annual Scientific Meeting in San Diego on’ October 15.
‘Many people have anxiety and uncertainty about the colonoscopy preparation, and what the colonoscopy is going to feel like,’ says Siegel, director of the Inflammatory Bowel Disease Center at Dartmouth-Hitchcock. ‘They also have concerns about what might be found during the procedure, and how it will be dealt with at the time of the colonoscopy.’
VIDEO:’ Watch Siegel and Zipursky discuss the trial and the results at’ http://youtu.be/3ulzMkKd9s0
On the day of the colonoscopy, prior to the procedure, participants in both groups were asked to fill out a survey to assess their knowledge of colonoscopy, their emotional state prior to the procedure, and their understanding of potential outcomes. The average procedure time and amount of pain medication administered were also measured.
The Results
Patients who viewed the Emmi Solutions colonoscopy program prior to their procedure had decreased anxiety, lower sedation medication requirements and shorter procedure times, compared with those who only received the standard printed pre-procedure packet. ‘Patients who watched the program were nearly universal in describing it as both helpful and informative,’ reported Parker.
‘This video allows us to give something to the patient to take with them so they can do some self-directed learning into their own health and into the procedure,’ says Zipursky. ‘It is really engaging them in their own care.’
The team concluded that the Emmi program not only increased patient knowledge and comfort levels, but may also lead to increased organizational efficiency and lower costs by saving staff time and using lower doses of sedative medications.
Patients who watched the Emmi program:
-’ ‘ ‘ ‘ ‘ ‘ ‘ ‘ ‘ ‘ Required 18percent’ less sedation medication
-’ ‘ ‘ ‘ ‘ ‘ ‘ ‘ ‘ ‘ Had a 14percent decrease in procedure time
-’ ‘ ‘ ‘ ‘ ‘ ‘ ‘ ‘ ‘ Were 11percent more knowledgeable about colonoscopy
What’s Next
Siegel and his team see this multi-media approach as having application across a number of clinical areas besides colonoscopy, leading to better patient experience and better outcomes. ‘As we’ve shown, patients are coming in for procedures less anxious, more knowledgeable and having maybe quicker and easier procedures, so it’s a nice combination,’ says Siegel. ‘If we can educate patients better, engage them in the process, and therefore lower their anxiety and worry, then it makes their experience better.’