Patient-reported adverse events after colonoscopy in Norway

Area of Science:

• Gastroenterology
• Health Services Research
• Patient Safety

Background:

• Patient-reported outcome measures (PROMs) are crucial in healthcare.
• European guidelines advocate for patient feedback on colonoscopy adverse events, yet implementation is limited.
• The Norwegian Quality Assurance network for endoscopy (Gastronet) collects PROMs for colonoscopies.

Purpose of the Study:

• To assess the feasibility and impact of using patient free-text comments to identify unreported adverse events following colonoscopy.
• To compare adverse event detection rates between standard colonoscopy reporting and patient feedback.

Main Methods:

• Analysis of free-text comments from 16,552 colonoscopies performed between January and December 2015.
• Categorization of comments as positive or negative.
• Scrutiny of negative comments for potential adverse events, including hospital admissions.

Main Results:

• 23% of patient feedback reports (2628/11,248) contained free-text comments.
• Negative comments revealed 15 unreported hospital admissions due to adverse events, increasing the total rate from 0.03% to 0.16%.
• An additional 14 severe events without hospital admission were reported by patients, totaling 29 missed severe adverse events.

Conclusions:

• Routine patient feedback is a feasible method to comprehensively capture colonoscopy-related adverse events.
• Significant patient complications can be missed by conventional documentation and registries.
• Tailored patient feedback forms are essential for identifying adverse events not otherwise disclosed.