- Email: [email protected]
Telemedicine in colorectal cancer screening
+Model
ARTICLE IN PRESS
CLINRE-871; No. of Pages 2
Clinics and Research in Hepatology and Gastroenterology (2016) xxx, xxx.e1—xxx.e2
Available online at
ScienceDirect www.sciencedirect.com
LETTER TO THE EDITOR Telemedicine in colorectal cancer screening Colorectal cancer is one of the most common forms of cancer in western countries and is the second cause of mortality linked to cancer [1]. Current scientific evidence supports the development of screening programs for colorectal cancer for individuals at high risk (relatives of patients with colorectal cancer) given its efectiveness [2]. The progressive implementation of these prevention programs in Spain will lead to an increase in the number of patients in outpatient consultations of gastroenterology. Thus, it would be interesting to find strategies that would reduce this overload. The aim of our study was to assess the satisfaction of a number of patients with teleconsultation in the context of a screening program of colorectal cancer. For this purpose, we conducted an interventional, multicenter and randomized study in a number of patients within a screening program of colorectal cancer in those with the removal of any polyp by colonoscopy. After that, the histological result of the resected polyp/s, the establishment under this data of the next colonoscopy and the period of time for it, and the recommendation of colonoscopy or other screening available tests for the first-degree relatives, were notified by phone (teleconsultation). Finally, a comparison of the satisfaction obtained was made in relation to a control group (conventional face to face consultation) by a previously validated satisfaction and summarized questionnaire [3] scored from 1 to 5 (Likert scale: strongly agree, agree, not sure, disagree and strongly disagree respectively, Box 1). The period of time of the study was from 1 July 2013 to 1 July 2015 in three hospitals belonging to the Alto Guadalquivir Healthcare Agency (Department of equality, health and social policies, Junta of Andalusia, Spain): Sierra de Segura and Alcaudete (Jaen, Spain) and Puente Genil (Cordoba, Spain). A total of 54 patients were included in the study, there were no rejections. Simple random sampling to each group (conventional consultation group vs teleconsultation/telemedicine group) of 27 patients respectively. The telemedicine group included 16 males (59.3%) and 11 females (40.7%) with a mean age of 58.15 (7.92) years old. The control group, 18 men (66.7%) and 9 women (33.3%) with a mean age of 55.44 (12.02) years old. There were no
Box 1: Summarized Satisfaction Questionnaire. 1. I’m very satisfied with the medical care I receive. 2. Doctors let their patients tell them everything that the patient thinks is important. 3. I think my doctor’s office has everything needed to provide complete medical care. 4. Doctors never keep their patient waiting, not even for a minute. 5. Places where you can get medical care are very conveniently located. 6. If I have a medical question, I can reach someone for help without any problem. 7. Doctors always treat their patients with respect. 8. Doctors explain the patient’s medical problems to him/her. 9. Doctors always do their best to keep the patient away from worrying. 10. Doctors are very thorough. 11. Doctors respect their patient’s feelings. 12. Sometimes doctors take unnecessary risks in treating their patients. 13. Sometimes doctors miss important information that their patients give them. Only teleconsultation group (unvalidated questionnaire): 14. If I had the chance, I would continue with telemedicine in other offices. 15. I recommend teleconsultation to my friends and family. 16. I think I’ve saved time with teleconsultation. 17. I think I’ve saved money with teleconsultation. 18. I’ve worried that someone listened in on the conversation with my doctor. Taken from Ware, et al. [3].
statistically significant differences between the groups of study. Overall satisfaction from the questionnaires was generally excellent in both groups, and in this sense, no statistically significant differences were found between them (Student’s t-test, P > 0.05). This circumstance shows that this strategy may be applied and also with good results.
http://dx.doi.org/10.1016/j.clinre.2016.02.009 2210-7401/© 2016 Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Cerezo-Ruiz A, Parras-Mejías E. Telemedicine in colorectal cancer screening. Clin Res Hepatol Gastroenterol (2016), http://dx.doi.org/10.1016/j.clinre.2016.02.009
+Model CLINRE-871; No. of Pages 2
ARTICLE IN PRESS
xxx.e2 Finally, we also have obtained optimum results in specific questionnaire, unvalidated, made to patients in the teleconsultation group, which takes into account concepts such as comfort, saving time and money. Derived from this measure, there might be an economic benefit, both direct and indirect, reasoned from the point of view of not being exactly physical consultation, lack of movement of the patient to the hospital and assistance for respective job for a day or for hours, which would support the definitive implantation of this strategy in consult. This matter has not been examined in this particular study. Summarizing, it is possible performing telemedicine in the context of colorectal cancer screening for those patients with removal of polyps after colonoscopy, with the same satisfaction to that obtained at conventional consult. Therefore, it would generate greater patient comfort and possibly profits.
Disclosure of interest The authors declare that they have no competing interest.
Letter to the editor
References [1] Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55(2):74—108. [2] Puente Gutiérrez JJ, Marín Moreno MA, Domínguez Jiménez JL, Bernal Blanco E, Díaz Iglesias JM. Effectiveness of a colonoscopic screening programme in first-degree relatives of patients with colorectal cancer. Colorectal Dis 2011;13(6):e145—53. [3] Ware Jr JE, Snyder MK, Wright WR, Davies AR. Defining and measuring patient satisfaction with medical care. Eval Program Plann 1983;6:247—63.
Antonio Cerezo-Ruiz a,∗ Encarnación Parras-Mejías b,1 a Department of gastroenterology, Sierra de Segura hospital, Puente de Genave-La Puerta de Segura Rd. km. 0,300, Jaen, Spain b Department of statistical analysis, Alto Guadalquivir healthcare agency, department of equality, healthcare and social policies, Junta of Andalusia, Spain ∗
Corresponding author. E-mail address: [email protected] (A. Cerezo-Ruiz) 1 http://www.asag.es.
Please cite this article in press as: Cerezo-Ruiz A, Parras-Mejías E. Telemedicine in colorectal cancer screening. Clin Res Hepatol Gastroenterol (2016), http://dx.doi.org/10.1016/j.clinre.2016.02.009
ARTICLE IN PRESS
CLINRE-871; No. of Pages 2
Clinics and Research in Hepatology and Gastroenterology (2016) xxx, xxx.e1—xxx.e2
Available online at
ScienceDirect www.sciencedirect.com
LETTER TO THE EDITOR Telemedicine in colorectal cancer screening Colorectal cancer is one of the most common forms of cancer in western countries and is the second cause of mortality linked to cancer [1]. Current scientific evidence supports the development of screening programs for colorectal cancer for individuals at high risk (relatives of patients with colorectal cancer) given its efectiveness [2]. The progressive implementation of these prevention programs in Spain will lead to an increase in the number of patients in outpatient consultations of gastroenterology. Thus, it would be interesting to find strategies that would reduce this overload. The aim of our study was to assess the satisfaction of a number of patients with teleconsultation in the context of a screening program of colorectal cancer. For this purpose, we conducted an interventional, multicenter and randomized study in a number of patients within a screening program of colorectal cancer in those with the removal of any polyp by colonoscopy. After that, the histological result of the resected polyp/s, the establishment under this data of the next colonoscopy and the period of time for it, and the recommendation of colonoscopy or other screening available tests for the first-degree relatives, were notified by phone (teleconsultation). Finally, a comparison of the satisfaction obtained was made in relation to a control group (conventional face to face consultation) by a previously validated satisfaction and summarized questionnaire [3] scored from 1 to 5 (Likert scale: strongly agree, agree, not sure, disagree and strongly disagree respectively, Box 1). The period of time of the study was from 1 July 2013 to 1 July 2015 in three hospitals belonging to the Alto Guadalquivir Healthcare Agency (Department of equality, health and social policies, Junta of Andalusia, Spain): Sierra de Segura and Alcaudete (Jaen, Spain) and Puente Genil (Cordoba, Spain). A total of 54 patients were included in the study, there were no rejections. Simple random sampling to each group (conventional consultation group vs teleconsultation/telemedicine group) of 27 patients respectively. The telemedicine group included 16 males (59.3%) and 11 females (40.7%) with a mean age of 58.15 (7.92) years old. The control group, 18 men (66.7%) and 9 women (33.3%) with a mean age of 55.44 (12.02) years old. There were no
Box 1: Summarized Satisfaction Questionnaire. 1. I’m very satisfied with the medical care I receive. 2. Doctors let their patients tell them everything that the patient thinks is important. 3. I think my doctor’s office has everything needed to provide complete medical care. 4. Doctors never keep their patient waiting, not even for a minute. 5. Places where you can get medical care are very conveniently located. 6. If I have a medical question, I can reach someone for help without any problem. 7. Doctors always treat their patients with respect. 8. Doctors explain the patient’s medical problems to him/her. 9. Doctors always do their best to keep the patient away from worrying. 10. Doctors are very thorough. 11. Doctors respect their patient’s feelings. 12. Sometimes doctors take unnecessary risks in treating their patients. 13. Sometimes doctors miss important information that their patients give them. Only teleconsultation group (unvalidated questionnaire): 14. If I had the chance, I would continue with telemedicine in other offices. 15. I recommend teleconsultation to my friends and family. 16. I think I’ve saved time with teleconsultation. 17. I think I’ve saved money with teleconsultation. 18. I’ve worried that someone listened in on the conversation with my doctor. Taken from Ware, et al. [3].
statistically significant differences between the groups of study. Overall satisfaction from the questionnaires was generally excellent in both groups, and in this sense, no statistically significant differences were found between them (Student’s t-test, P > 0.05). This circumstance shows that this strategy may be applied and also with good results.
http://dx.doi.org/10.1016/j.clinre.2016.02.009 2210-7401/© 2016 Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Cerezo-Ruiz A, Parras-Mejías E. Telemedicine in colorectal cancer screening. Clin Res Hepatol Gastroenterol (2016), http://dx.doi.org/10.1016/j.clinre.2016.02.009
+Model CLINRE-871; No. of Pages 2
ARTICLE IN PRESS
xxx.e2 Finally, we also have obtained optimum results in specific questionnaire, unvalidated, made to patients in the teleconsultation group, which takes into account concepts such as comfort, saving time and money. Derived from this measure, there might be an economic benefit, both direct and indirect, reasoned from the point of view of not being exactly physical consultation, lack of movement of the patient to the hospital and assistance for respective job for a day or for hours, which would support the definitive implantation of this strategy in consult. This matter has not been examined in this particular study. Summarizing, it is possible performing telemedicine in the context of colorectal cancer screening for those patients with removal of polyps after colonoscopy, with the same satisfaction to that obtained at conventional consult. Therefore, it would generate greater patient comfort and possibly profits.
Disclosure of interest The authors declare that they have no competing interest.
Letter to the editor
References [1] Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55(2):74—108. [2] Puente Gutiérrez JJ, Marín Moreno MA, Domínguez Jiménez JL, Bernal Blanco E, Díaz Iglesias JM. Effectiveness of a colonoscopic screening programme in first-degree relatives of patients with colorectal cancer. Colorectal Dis 2011;13(6):e145—53. [3] Ware Jr JE, Snyder MK, Wright WR, Davies AR. Defining and measuring patient satisfaction with medical care. Eval Program Plann 1983;6:247—63.
Antonio Cerezo-Ruiz a,∗ Encarnación Parras-Mejías b,1 a Department of gastroenterology, Sierra de Segura hospital, Puente de Genave-La Puerta de Segura Rd. km. 0,300, Jaen, Spain b Department of statistical analysis, Alto Guadalquivir healthcare agency, department of equality, healthcare and social policies, Junta of Andalusia, Spain ∗
Corresponding author. E-mail address: [email protected] (A. Cerezo-Ruiz) 1 http://www.asag.es.
Please cite this article in press as: Cerezo-Ruiz A, Parras-Mejías E. Telemedicine in colorectal cancer screening. Clin Res Hepatol Gastroenterol (2016), http://dx.doi.org/10.1016/j.clinre.2016.02.009