Does Pre-Procedural Counseling by Peers Improve Completion Rates?

Abstract

Purpose: The aim of this study is to examine the relationship between improved health literacy and patient compliance with gastrointestinal procedures when pre-procedural counseling is provided by peers. Methods: At an ambulatory clinic, the completion rate of 267 consecutive patients scheduled for 297 gastrointestinal procedures (colonoscopy, EGD, ERCP, EUS, or flexible sigmoidoscopy) who received pre-procedural counseling was compared with the completion rate of 326 consecutive patients scheduled for 331 procedures who did not receive this intensive counseling. A second comparison was made between groups that compared adherence to the originally scheduled appointment among those patients who followed up for their procedure. Results: Pre-procedural counseling increases the completion rate of EGD (85.9% compared to 74.6) but does not increase overall colonoscopy completion rates (70.3% compared to 70.8%). However, patients who have received pre-procedural counseling are more likely than those who have not received counseling to attend their originally scheduled appointment, regardless of the type of procedure (75.3% compared to 56.2% for EGD; 64.6% compared to 56.2% for colonoscopy). Conclusion: Providing patients who may have limited health literacy with pre-procedural counseling can help improve timely completion of necessary gastrointestinal procedures. Counseling significantly improves patient compliance with EGD and compliance with originally scheduled EGD and colonoscopy appointments, while overall compliance with colonoscopy remains poor.