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Overcoming Colonoscopy Fears

November 26, 2013
Lebanon, NH

According to a recent study, 40 percent of all cases of colon cancer could be prevented with regular screenings. While the medical community recommends that people begin getting colonoscopies soon after turning 50, many skip them, citing anxieties. The results of a recent study at Dartmouth-Hitchcock show that patient education and engagement can actually lower anxiety before a colonoscopy.

Narrator: Dr Corey Siegel is no stranger to [patients with] colonoscopy jitters. He knows that fear of the unknown holds a lot of people back. In fact, 28 percent of those over 50 have not been screened for colon cancer, largely due to fears about the preparation and the procedure itself. Fourth year D-H medical student Jonathan Zipursky, now a second year resident at the University of Toronto, posed the question: Is there a way to reduce anxiety about the procedure for first-time colonoscopy patients?

Jonathan Zipursky, MD, University of Toronto: I thought this would be an interesting opportunity to use a flash video or multi-media platform to educate patients about this procedure.

Narrator: A randomized control trial was set up using a multi-media patient education tool created by EMMI Solutions.

EMMI Program: You're getting a colonoscopy to catch problems.

Narrator: Half of the patients watched the web-based multi-media program; the other half were given a standard education package.

Corey Siegel, MD: We found that patients who viewed the video did have significantly decreased anxiety and actually increased their knowledge, as we would expect. But, more so, actually had lower doses of sedation medications during the procedure and shorter procedure times.

Jonathan Zipursky, MD: We validated our hypothesis; what we had hoped to find.

Narrator: Zipursky says it's often helpful to have something more visual to help explain a procedure to a patient.

Jonathan Zipursky, MD: This video allows us to give something to the patient to take with them and play it as many times as they want so they can do some self-directed learning into their own health and into the procedure. It is really engaging them in their own care.

Corey Siegel, MD: Based on these results I think it's a tool that we want to give to our patients. It's virtually a free intervention. We simply give them a web link to go to the video and watch it.
It's really no extra work for our staff; yet, as we've shown, patients are coming in for procedures less anxious, more knowledgeable, having maybe quicker and easier procedures. So, it's a nice combination.

Jonathan Zipursky, MD: A tool like this could be used for a whole variety of things.

Corey Siegel, MD: We here at Dartmouth are working in collaboration with EMMI to use a number of their decision making and education tools. If we can educate patients better, engage them in the process, and therefore, lower their anxiety and worry, then it makes their experience better.

The study was conducted by Corey Siegel, MD along with Geisel School of Medicine graduate Jonathan Zipursky, MD, now at the University of Toronto, Geisel Medical Student Helen Ma, and Gastroenterology fellow Siddhartha Parker, MD. Dr. Parker presented the findings at the 2013 American College of Gastroenterology Annual Scientific Meeting in San Diego, October 15.

To learn more about the importance of screening tests visit http://www.cdc.gov/VitalSigns/colorectalcancerscreening/index.html

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