Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysis

Objectives Screening in selected high risk populations for Barrett’s oesophagus (BO) and oesophageal varices (OVs) has been proposed, but there are obstacles with conventional oesophagogastroduodenoscopy (C-OGD), including patient acceptability. Portable and disposable office-based transnasal endosc...

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Main Authors: Laurence B Lovat, Sarmed S Sami, Krish Ragunath, John Mcgoran, John De Caestecker, Andrea Bennett, Joanne Cooper, Neil Guha
Format: Article
Language:English
Published: BMJ Publishing Group 2019-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/12/e030467.full
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author Laurence B Lovat
Sarmed S Sami
Krish Ragunath
John Mcgoran
John De Caestecker
Andrea Bennett
Joanne Cooper
Neil Guha
author_facet Laurence B Lovat
Sarmed S Sami
Krish Ragunath
John Mcgoran
John De Caestecker
Andrea Bennett
Joanne Cooper
Neil Guha
author_sort Laurence B Lovat
collection DOAJ
description Objectives Screening in selected high risk populations for Barrett’s oesophagus (BO) and oesophageal varices (OVs) has been proposed, but there are obstacles with conventional oesophagogastroduodenoscopy (C-OGD), including patient acceptability. Portable and disposable office-based transnasal endoscopy (TNE) is a feasible and accurate alternative to C-OGD that may have use in primary and secondary care. This article outlines a qualitative analysis of patient experiences of TNE and C-OGD in order to gain an insight into an acceptable delivery of an endoscopic screening service.Design Purposeful sampling identified 23 participants who then underwent semi-structured interviews to determine their experiences of both procedures. Thematic analysis was conducted to derive meaning from their lived experiences.Setting A secondary care endoscopy unit, clinic room and interview room.Participants Patients referred for BO or OV surveillance and for endoscopy to investigate dyspepsia underwent unsedated TNE using the EG Scan II device followed by C-OGD with or without sedation (patient choice), as part of a clinical trial.Results The themes that arose from our analysis were: inclusivity in one’s own healthcare, comfort level and convenience, validity of the procedure and application to a screening population and a sense of altruism and reciprocity. Positive aspects of TNE included participant empowerment, reduced discomfort and avoidance of conscious sedation. Participants felt that if TNE screening was of proven efficacy it would be welcomed, though views on use in a community setting were mixed.Conclusions Most patients preferred TNE to unsedated C-OGD and the reasons they gave featured strongly in the emerging themes. Preferences between TNE and sedated C-OGD were more subtle, with equivalent comfort scores but merits and drawbacks of both being discussed. This information identifies opportunities and challenges in establishing an endoscopic screening service.Trialregistration numberISRCTNregistry identifier: 70595405; Pre-results.
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spelling doaj-art-fa60b5608a6648aa89c548d9088ba08b2025-08-20T02:07:20ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-030467Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysisLaurence B Lovat0Sarmed S Sami1Krish Ragunath2John Mcgoran3John De Caestecker4Andrea Bennett5Joanne Cooper6Neil Guha71 Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK21 Gastroenterology, University College London Hospitals NHS Foundation Trust, London, UKDepartment of Gastroenterology & Hepatology, Royal Perth Hospital, Perth, Western Australia, AustraliaGastroenterology, Belfast Health and Social Care Trust, Belfast, UK1 Digestive Diseases Centre, University Hospitals of Leicester NHS Trust, Leicester, UK2 National Institute for Health Research (NIHR) Biomedical Research Center in Gastrointestinal and Liver Diseases, Nottingham University Hospitals NHS Trust, Nottingham, Nottingham, UKNottingham University Hospitals NHS Trust, Nottingham, UKNIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UKObjectives Screening in selected high risk populations for Barrett’s oesophagus (BO) and oesophageal varices (OVs) has been proposed, but there are obstacles with conventional oesophagogastroduodenoscopy (C-OGD), including patient acceptability. Portable and disposable office-based transnasal endoscopy (TNE) is a feasible and accurate alternative to C-OGD that may have use in primary and secondary care. This article outlines a qualitative analysis of patient experiences of TNE and C-OGD in order to gain an insight into an acceptable delivery of an endoscopic screening service.Design Purposeful sampling identified 23 participants who then underwent semi-structured interviews to determine their experiences of both procedures. Thematic analysis was conducted to derive meaning from their lived experiences.Setting A secondary care endoscopy unit, clinic room and interview room.Participants Patients referred for BO or OV surveillance and for endoscopy to investigate dyspepsia underwent unsedated TNE using the EG Scan II device followed by C-OGD with or without sedation (patient choice), as part of a clinical trial.Results The themes that arose from our analysis were: inclusivity in one’s own healthcare, comfort level and convenience, validity of the procedure and application to a screening population and a sense of altruism and reciprocity. Positive aspects of TNE included participant empowerment, reduced discomfort and avoidance of conscious sedation. Participants felt that if TNE screening was of proven efficacy it would be welcomed, though views on use in a community setting were mixed.Conclusions Most patients preferred TNE to unsedated C-OGD and the reasons they gave featured strongly in the emerging themes. Preferences between TNE and sedated C-OGD were more subtle, with equivalent comfort scores but merits and drawbacks of both being discussed. This information identifies opportunities and challenges in establishing an endoscopic screening service.Trialregistration numberISRCTNregistry identifier: 70595405; Pre-results.https://bmjopen.bmj.com/content/9/12/e030467.full
spellingShingle Laurence B Lovat
Sarmed S Sami
Krish Ragunath
John Mcgoran
John De Caestecker
Andrea Bennett
Joanne Cooper
Neil Guha
Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysis
BMJ Open
title Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysis
title_full Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysis
title_fullStr Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysis
title_full_unstemmed Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysis
title_short Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysis
title_sort acceptability to patients of screening disposable transnasal endoscopy qualitative interview analysis
url https://bmjopen.bmj.com/content/9/12/e030467.full
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