Randomized trial of an enhanced consultation versus standard consultation for prolapse: impact on patient satisfaction

• Published in: International Urogynecology Journal Vol. 33; no. 7; pp. 1967 - 1971
• Main Authors: Liao, Christina, Laus, Katharina, Yazdany, Tajnoos
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-07-2022; Springer Nature B.V
• Subjects: Animation; Counseling; Gynecology; Health education; Health literacy; Interpreters; Knowledge; Medicine; Medicine & Public Health; Obstetrics; Original Article; Patient satisfaction; Pelvic organ prolapse; Questionnaires; Urology; Vagina; Visual aids; Womens health; Visual aid; Pelvic organ prolapse; Decisional conflict; Spanish-speaking women
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-021-04959-9

Introduction and hypothesis
Optimal counseling techniques for Spanish-speaking patients with low health literacy and pelvic organ prolapse (POP) is unknown. We hypothesize that with use of an enhanced consultation (EC) strategy, patient satisfaction with their knowledge of prolapse will improve compared with a standard consultation (SC).
Methods
We conducted a randomized controlled trial of an EC vs SC in Spanish-speaking women seeking treatment for POP. In addition to receiving the same SC as the SC group, the EC group received consultation using images from an Interactive Pelvic Organ Prolapse Quantification (POPQ) Program and a brief anatomy lesson. Thirty participants per group was calculated to achieve a power of 80% with an alpha of 0.05. The primary outcome was to assess the change in patient satisfaction of prolapse understanding utilizing a visual analog scale. Comparisons between groups were done using Student’s
t
test or Wilcoxon Rank-Sum for continuous variables, Mantel–Haenszel for ordinal variables, and Chi-squared and Fisher’s exact tests for categorical variables.
Results
A total of 78 patients were enrolled and 64 completed the study. There was no difference in the change in satisfaction with disease understanding on a visual analog scale between the EC and SC groups (45.6 vs 51.7,
p
 = 0.623). There were no differences in the change in factual knowledge scores on the prolapse portion of the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) between the EC and the SC groups (19.6 vs 18.9,
p
 = 0.914).
Conclusions
In Spanish-speaking women, an EC using a 2-D prolapse animation did not increase prolapse knowledge satisfaction of disease understanding compared with an SC.