The majority of patients reported a willingness to undergo elective endoscopic procedures during the reopening period of the COVID-19 pandemic, according to study results published in Gastroenterology.

Though many endoscopy units are reopening for elective procedures, patient perceptions regarding the risk of COVID-19 exposure remain unknown. Researchers conducted a survey of patients to describe their perspectives on the reopening effort. Patients eligible for the survey were those who had elective procedures scheduled between late March and April 2020 that were either rescheduled or cancelled due to the pandemic. The researchers solicited perceptions in 2 domains: willingness to undergo endoscopy during the pandemic with no effective treatment or vaccine available, as well as willingness to proceed upon adoption of new safety measures in hospitals. Patient responses to the value of protective measures were scored on a scale of 0 to 3. A score of 0 was assigned to “no value”, 1 to “little value,” 2 to “important, should be done,” and 3 to “critical”. Patients’ responses regarding concern over acquiring infection and willingness to undergo elective procedures with and without critical protective measures were statistically analyzed.

In total, 231 patients agreed to participate in the survey (mean age, 58.9 years ± 14.3; 59% female).  Of these, 84% were sheltering in place, 66% were married, 36% had children living had home, and 7% were caretakers, parents, or had parents at home. Approximately 98% of the cohort reported no symptoms of COVID-19 and did not undergo testing. When assessing level of concern, 44% of patients were “very” or “somewhat” concerned about acquiring COVID-19 by undergoing endoscopy. Patients without children at home were more concerned than those with children at home (50% vs 35%; P =.026).  When asked if willing to undergo endoscopic procedure in May 2020, 75% of all respondents replied that they were willing, with 47% preferring a free-standing endoscopy unit, 20% preferring endoscopy in a hospital, and 33% indicating no preference. Gender, age, and parents at home had no association with level of concern or willingness to proceed with endoscopy. Respondents ranked the use of surgical masks by all medical staff as the most important measure followed by the provision of masks to patients and weekly COVID-19 testing of staff. When all measures considered critical were in place, 83% of patients (95% CI, 77.7-87.7) responded that they would proceed with scheduled procedures compared to 75% (95% CI, 68.3-79.9) who would proceed without protective measures being implemented (P =.002).


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Limitations of the study included the lack of generalizability and that patient perceptions may not reflect actual behaviors.

The authors concluded that “most patients were willing to undergo endoscopy despite 44% being very or somewhat concerned about acquiring COVID-19 by attending.”

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Reference

Rex K, Vemulapalli KC, Kane MJ, McHenry Jr L, Sherman S, Al-Haddad M. Most patients are willing to undergo elective endoscopic procedures during the reopening period of the COVID-19 pandemic (published online May 16, 2020). Gastroenterology. doi: 10.1053/j.gastro.2020.05.039