How thorough is the process of informed consent prior to outpatient gastroscopy? A study of practice in a United Kingdom District Hospital

Abstract

Background/aims: Informed consent for outpatient gastroscopy should involve many elements and many patients may not have spoken to an endoscopist beforehand. The aim was to audit the completeness of the consent process in patients undergoing outpatient gastroscopy.

Methods: This is a retrospective study in which a 37-point questionnaire was sent to 200 patients who had undergone outpatient gastroscopy. Questions covered information given before and on the day of the procedure.

Results: The response rate was 71.5% (143/200) and 141 questionnaires were analysed. Before the day of the procedure: 92.2% understood why they were having a gastroscopy, 90.8% had the procedure explained to them and of these 96.1% understood the explanation. 48.9% were told the risks of the procedure, 51.8% were given the opportunity to decline, but only 11.3% were told of an alternative to the procedure and 24.1% of possible consequences of not having the test. On arrival at the endoscopy unit: 92.2% of respondents had the procedure explained to them but only 55.4% received an explanation from the endoscopist. 45.4% were told the risks of the procedure, 48.2% were given the opportunity to decline. 39.0% did not read the consent form before signing and, of those that did, 98.7% understood it.

Conclusion: Nearly all the patients understood the nature of gastroscopy and the reasons for the test before attending; however, there was poor explanation of the risks of gastroscopy and of its alternatives. Approximately half the patients were not given the opportunity to decline gastroscopy either before or on the day of the procedure.