947 The use of portable video media versus standard verbal communication in the urological consent process: A randomised controlled clinical trial

INTRODUCTION AND OBJECTIVES: Technology can be used to improve patient care, especially regarding informed consent. The aim of our study is to determine patient satisfaction and knowledge acquired during the consent process for cystoscopy and insertion of a ureteric stent, comparing the use of standard verbal communication (SVC) to portable video media (PVM). METHODS: A randomized controlled cross-over trial was performed enrolling patients presenting with acute colic requiring a ureteric stent. Patients were randomised to receive either SVC or PVM prior to procedure. A validated questionnaire (CSQ-8 max score 32) assessing patient satisfaction and a 28-point questionnaire assessing understanding of the critical components of the procedure was then completed. The groups were then crossed over and questionaries retested. Patients were asked to give their overall preference at the conclusion of both delivery methods. SVC involved the typical verbal interaction required for consent. The PVM consisted of an audio-visual presentation with cartoon animation presented on an iPad. RESULTS: Eighty patients were randomly assigned and completed the trial. 36 patients received PVM as the first intervention and 44 patients received SVC as the first intervention and then crossover was performed according to protocol. Recruitment was completed over two sites over a 15-month period (July 2014 to Oct 2015). Mean age of participants was 54 years old. 21 (26%) patients were female and 59 (74%) male. Mean SVC time was 4.34min. The patient satisfaction as measured by CSQ-8 was the same between groups (mean PVM 30.30 v SVC 29.1, p1⁄40.119). A 15.2% increase in understanding, as assessed by the 28-point questionnaire, was demonstrable favouring the use of PVM (mean PVM 23.06 v SVC 20.02, p1⁄40.001). Upon group crossover analysis, a 18.5% increase in MCQ score was seen when the SVC group were crossed over to the PVM arm (pu003c0.001). No increase in MCQ score was seen when crossover from PVM to SVC was performed (p1⁄40.893). A total of 81% (n1⁄465) patients preferred PVM and 19% (n1⁄415) preferred SVC. CONCLUSIONS: This study demonstrates patient preference towards PVM in the urological consent process of cystoscopy and ureteric stent insertion. PVM appears to be a more effective means of content delivery to patients, in the acute hospital setting, in terms of overall preference andknowledgegained.PVMisauseful adjunct toSVCfor informedconsent and could be extended to many other procedural consents.