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Gastroenterology and hepatology
Original research
Acceptability to patients of screening disposable transnasal endoscopy: qualitative interview analysis
  1. John McGoran1,
  2. Andrea Bennett2,
  3. Joanne Cooper2,
  4. John De Caestecker1,
  5. Laurence B Lovat3,
  6. Neil Guha2,
  7. Krish Ragunath2,
  8. Sarmed S Sami3
  1. 1 Digestive Diseases Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2 National Institute for Health Research (NIHR) Biomedical Research Center in Gastrointestinal and Liver Diseases, Nottingham University Hospitals NHS Trust, Nottingham, Nottingham, UK
  3. 3 Division of Surgery and Interventional Science, University College London, London, London, UK
  1. Correspondence to Dr Sarmed S Sami; s.sami{at}ucl.ac.uk

Abstract

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.

Trial registration number

ISRCTNregistry identifier: 70595405; Pre-results.

  • endoscopy
  • oesophageal disease
  • hepatology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-030467

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    Footnotes

    • Twitter @drjo_cooper

    • Contributors JM: contributed to analysis, interpretation of data and drafted the manuscript. AB: contributed to the acquisition of data and critical revision of the manuscript for important intellectual content. JC: contributed to acquisition of data, interpretation of data and critical revision of the manuscript for important intellectual content. JDC: contributed to the study supervision, interpretation of data and critical revision of the manuscript for important intellectual content. LBL: contributed to the study supervision, interpretation of data and critical revision of the manuscript for important intellectual content. NG: contributed to the acquisition of data, study supervision, interpretation of data and critical revision of the manuscript for important intellectual content. KR: contributed to the conception, design and supervision of the study, acquisition of data, study supervision, interpretation of data and critical revision of the manuscript for important intellectual content. SSS: contributed to the conception, design and supervision of the study, acquisition of data, analysis, interpretation of data and critical revision of the manuscript for important intellectual content.

    • Funding SSS was funded by an Olympus-Core National Endoscopy Research Fellowship grant, Core Charity, United Kingdom (grant number: RB4803). This study was part funded by a grant from Intromedic Ltd, Seoul, South Korea.

    • Competing interests KR is a research grant recipient from Intromedic Ltd, Seoul, South Korea.

    • Patient consent for publication Not required.

    • Ethics approval The East Midlands division of the Research Ethics Committee granted approval for the study (REC reference 12/EM/0100).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.