Patient-reported outcome measures after endoscopic retrograde cholangiopancreatography: a prospective, multicentre study

Abstract

Objective. While patient-reported outcome measures (PROMs) in ERCP are scarce, these reports are important for making improvements in quality of care. This study sought to document patient satisfaction and specifically pain related to endoscopic retrograde cholangiopancreatography (ERCP) procedures and to identify predictors for these experiences. Methods. From 2007 through 2009, prospective data from consecutive ERCP procedures at 11 hospitals during normal daily practice were recorded. Information regarding undesirable events that occurred during a 30-day follow-up period was also reported. The patient-reported pain, discomfort and general satisfaction with the ERCP were recorded. Results. Data from 2808 ERCP procedures were included in this study. Patient questionnaires were returned for 52.6% of the procedures. Moderate or severe pain was experienced in 15.5% and 14.0% of the procedures during the ERCP and in 10.8% and 7.7% of the procedures after the ERCP, respectively. In addition, female gender, endoscopic sphincterotomy (EST), and longer procedure times served as independent predictors of increased pain during the ERCP. The performing hospitals and sedation regimens were independent predictors of the procedural pain experience. In 90.9% of the procedures, the patients were satisfied with the information overall, and in 98.3% of the procedures, the patients were satisfied with the treatment provided. Independent predictors of dissatisfaction with the treatment included the occurrence of specific complications after ERCP and pain during or after the procedure. Conclusions. Female gender, the performance of EST and longer procedure times were independent predictors for increased procedure-related pain. The individual hospital and sedation regimen predicts the patient's pain experience.

Key Words::

• ERCP
• pain
• PROMs
• risk factors

Acknowledgements

Data collection was organized and coordinated by the Gastronet, and the contributions made by the Gastronet secretariat and the staff and nurses at the participating hospitals and ERCP units are very much appreciated. We also acknowledge support and funding offered by the Norwegian Gastroenterological Association (NGA) and the Folke Hermansens Cancer Research Fund, Stavanger (StHF # 424501).

Declaration of interest: There are no conflicts of interest related to this study and its publication. The Regional Health Trust of South-Eastern Norway and the Regional Health Trust of Western Norway provided financial support to the Gastronet group. This study was also funded and supported in part by the Folke Hermansens Cancer Research Fund, Stavanger (StHF # 424501) and the Norwegian Gastroenterological Association.