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Electronic letters published:
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif){kind=icon}
Distribution of Patient Brochures: A pragmatic solution to resolving the information gap
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Pascal Vignally, Ph D Laboratoire Sante publique, Faculte de Medecine, Marseille, France, Stephanie Gentile, Nancy Binkin, Jean Charles Grimaud
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pascal.vignally{at}ap-hm.fr Pascal Vignally, et al.
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The study of Denberg el al illustrates the problems of providing patients with information to improve adherence with routine but invasive examinations such as colonoscopy. This procedure is often prescribed by a general practitioner (GP) but conducted by a specialist. The GP may not have the time or skills to provide the patient with necessary information about the procedure or its potential benefits and risks, while the specialist usually sees the patient for the first time on the day that the procedure is to be performed. As a result, the information that the patient receives is often unclear or incomplete. The legal obligation of providing clear and complete information to patients has led to the development of new approaches in fields such as anesthesiology (1,2). We evaluated the effects of applying one such approach on patient knowledge and satisfaction with colonoscopy. In our study, we randomized 34 patients who had been referred for colonoscopy, drawn from the practices of 11 GPs, into 2 groups. The first received a brochure from their GP that had been developed by the French gastroenterology society; they also had access to special consultation with a member of the colonoscopy team if they desired. The second received routine information. Knowledge of benefits and risks and satisfaction with the care they had received were evaluated via patient interview 2 days after the procedure. The group receiving the brochure, 20% of whom also took advantage of the special consultation service, had higher knowledge levels compared to the routine information group 5.2 ± 2.1 versus 3.3 ± 2.1 (p<0.04) on a 8 points scale, as well as a higher level of satisfaction with the medical care, 24.9 ± 4.6 versus 23.0 ± 5.1 (p<0.03) on a 30 points scale. This study demonstrated that knowledge levels were low in those who did not receive the brochure and did not have access to consultation, and that such an intervention increased both knowledge and patient satisfaction. In the context of increasing litigation between patients and practitioners such lack of knowledge may be highly damaging for practitioners (3). Indeed, Neale’s study demonstrated that 33% of litigations for colonoscopy were linked with misinformation, especially concerning possible complications (4). Although providing optional consultation with members of the specialist team may not be feasible in all settings, the distribution by GPs of patient brochures developed by specialists may be a pragmatic solution to resolving the information gap. If patients receive the brochure far enough in advance of the procedure, they would presumably have time to assimilate the information, and those wishing further clarification would be able to seek answers from specialists in the field. 1.Loi n° 2002-303 du 4 mars 2002 relative aux droits des malades et à la qualité du système de santé. JO n° 54. p 4118 2.Grimaud JC. Proof of information delivered to patients. Gastroenterol Clin Biol. 2003 Jan; 27(1):15-6 3.Studdert DM, Mello MM, Gawande AA et al. Claims, errors, and compensation payments in medical malpractice litigation. N Engl J Med. 2006 May 11;354(19):2024-33 4.Neale G. Reducing risks in gastroenterological practice. Gut 1998; 42: 139-42 Conflict of Interest:None declared |
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