Prospective randomized pilot study of a novel patient-centered pathology report for colorectal polyps

Cynthia W Ko; Lisa K Koch; Elizabeth J Austin; Elena G Brewer; Colton Johnson; Sarah K Holt; Mark Derleth; Margaret Eugenio; John L Gore

doi:10.1016/j.pecinn.2023.100238

Prospective randomized pilot study of a novel patient-centered pathology report for colorectal polyps

PEC Innov. 2023 Nov 28:3:100238. doi: 10.1016/j.pecinn.2023.100238. eCollection 2023 Dec 15.

Authors

Cynthia W Ko¹, Lisa K Koch^{2

3}, Elizabeth J Austin⁴, Elena G Brewer⁵, Colton Johnson¹, Sarah K Holt⁶, Mark Derleth¹, Margaret Eugenio¹, John L Gore^{5

6

7}

Affiliations

¹ Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, USA.
² Department of Pathology & Laboratory Medicine, University of Washington, Seattle, USA.
³ Avero Diagnostics, Bellingham, USA.
⁴ Department of Health Systems and Population Health, University of Washington, Seattle, USA.
⁵ Department of Surgery, University of Washington, Seattle, USA.
⁶ Department of Urology, University of Washington, Seattle, USA.
⁷ Fred Hutchinson Cancer Center, Seattle, USA.

Abstract

Objective: US patients have increased access to their medical records, yet the information is not always understandable. To improve patient understanding, we tested a patient-centered pathology report (PCPR) containing results for recent colon cancer screening or surveillance colonoscopy.

Methods: A pilot randomized trial assessed the impact of addition of the PCPR to a standard pathology report on knowledge accuracy, decisional self-efficacy and control, and therapeutic alliance.

Results: 55 participants were enrolled; 20 participants in the intervention group and 24 controls completed follow-up. There was no significant difference in polyp knowledge between groups at baseline or 30-days, with similar confidence in understanding their diagnoses, decisional self-efficacy, and therapeutic alliance. Most participants receiving a PCPR felt that it helped them understand their diagnosis better and should always be provided with the standard pathology report.

Conclusion: Although patient attitudes toward the PCPR were positive, receiving it did not significantly improve knowledge accuracy or measures of self-efficacy. Further iterations should be explored to communicate key knowledge about colorectal polyp results.

Innovation: A stakeholder-driven approach to PCPR development facilitated construction of a personalized document that has potential to increase patient's understanding for their results and needed follow-up.

Keywords: Cancer pathology; Colonoscopy; Colorectal polyp; Health communication; Patient-centered care.