Patient Perspectives on ACE (At-home video Capsule Endoscopy) : A Novel Approach to Gastrointestinal Endoscopy

Aims Video capsule Endoscopy involves patients swallowing a battery-powered capsule containing a small miniature camera to capture images of the gastrointestinal (GI) tract. Unlike traditional GI investigations, this procedure allows patients to maintain their daily routines while the capsule is in transit, offering comfort, reduced embarrassment, and a non-invasive nature of GI examination. During the Covid-19 pandemic, an "At-home Capsule Endoscopy" (ACE) was developed by University College London Hospital, allowing patients to complete the test remotely with virtual medical support. This study evaluates patient perceptions and satisfaction with ACE.

Methods Between April 2021 and June 2022, 100 patients that underwent ACE were offered a self-reported, anonymous questionnaire. The questionnaire featured five-point Likert response options (“to a very small extent”, “to a small extent”, “somewhat”, “to a large extent” and “to a very large extent”) and inquired about their experiences and perceptions before, during and after the ACE. Additional inquiries included overall satisfaction on a scale of 1 to 10 and preferences for future bowel investigations, with more emphasis on the lower GI tract. Descriptive statistics were used for data analysis.

Results A total of 84 (84% response rate) patients completed post-ACE questionnaires. The average age was 40 years (SD 15.9, Range 15-85), 60.63% were females. Nearly 95% of patients reported adequate support from hospital staff during ACE. The vast majority of patients reported being able to swallow the capsule without any problems (91.3%), did not report pain (92.1%), embarrassment (96.1%) or tiredness from the procedure (59.8%). Significantly, almost 80% expressed high satisfaction levels ('to a large' or 'very large extent') with the at-home procedure, and 83.3% preferred future tests to be conducted at home rather than in a hospital setting. A considerable portion of ACE patients (42.9%) maintained regular work activities on the test day, while 5 respondents (5.9%) took only a half day off, and 26 respondents (31%) took a full day off from work, (20.2% no response). Many respondents indicated that if the procedure had been administered at the hospital, they would have needed to take a full day off from work (54.2%) and incurred up to atleast £10 in transportation costs (54.2%).

Conclusions This study is the first to present patient experience data on at home capsule endoscopy and demonstrates it is both feasible and well-received by patients in terms of not causing pain, embarrassment or anxiety and saving time off work. Our findings indicate the potential of ACE as a more attractive, favorable, and less disruptive alternative to traditional at hospital GI investigations, such as conventional colonoscopy. Future research should compare remote with on-site capsule endoscopy to further elaborate on true patients' preferences and identify specific patient groups that might benefit more from this approach.

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Artikel online veröffentlicht:
15. April 2024