# Patient experiences of colon capsule endoscopy: a qualitative study

## TL;DR

This study explores how patients experienced colon capsule endoscopy, highlighting both its convenience and the anxieties it caused, especially among women.

## Contribution

The study provides new insights into patient-centered improvements needed for colon capsule endoscopy services, particularly regarding communication and gender-specific experiences.

## Key findings

- Most patients valued CCE's convenience but experienced anxieties about the procedure.
- Women reported greater discomfort and anxiety compared to men during CCE.
- Patients felt poorly informed and suggested clearer communication about potential follow-up procedures.

## Abstract

Colon capsule endoscopy (CCE) was introduced by NHS England at scale during the COVID-19 pandemic to support colorectal diagnostics recovery. However, little was known about the patient experience of CCE.

To explore the experiences of CCE during the NHS England pilot, to better understand what a patient-centered service for the future should look like.

A qualitative study to explore the patient and clinician experiences of CCE.

Focus group discussions (n = 25 participants) and semi-structured interviews (n = 7), selected purposively on the basis of maximum variation, generated qualitative material exploring patient understanding, preferences and experiences. To place their experiences in context, we conducted asynchronous focus group discussions with clinicians (n = 16). Analysis was thematic.

Most patients valued CCE’s convenience and would repeat it, although for some their experiences would deter them from having the procedure again. Anxieties included fear when swallowing the capsule; concerns about it becoming stuck and/or whether the recording was working; what to do when the capsule was inside them; and worries about the novelty of the treatment. Women expressed greater discomfort, pain and anxieties during bowel preparation and the procedure than men. Participants highlighted the need for a more balanced description of the procedure than indicated in information leaflets and videos. They particularly felt the possibility of further investigations could be better explained. Healthcare professionals may underestimate patient concerns.

CCE has the potential to expand colorectal diagnostic capacity but requires patients to be well informed and supported throughout the process. Gender differences in experiences of CCE are notable and could be partially addressed by providing more specific information, consistent with women’s experiences.

What is already known on this topic

Colon capsule endoscopy (CCE) was introduced by NHS England as a pilot from 2020, but patient experiences remain underexplored. There are also no defined key performance indicators to inform the development of a high-quality, patient-centred CCE service for the NHS.

Colon capsule endoscopy (CCE) was introduced by NHS England as a pilot from 2020, but patient experiences remain underexplored. There are also no defined key performance indicators to inform the development of a high-quality, patient-centred CCE service for the NHS.

What this study adds

This study finds patients view CCE positively and may prefer it over colonoscopy, though many report discomfort and anxiety. They also feel poorly informed.During the pandemic. healthcare professionals may have underestimated patients’ concerns about the procedure.

This study finds patients view CCE positively and may prefer it over colonoscopy, though many report discomfort and anxiety. They also feel poorly informed.

During the pandemic. healthcare professionals may have underestimated patients’ concerns about the procedure.

How this study might affect research, practice or policy

Patients’ experience of CCE differs from colonoscopy.Relevant information, shared decision making and support are required throughout the CCE process.Information on the procedure may require rewriting to reflect the experiences of women.Acceptance of CCE, including at home or primary care use, depends on addressing these needs and managing expectations about potential follow-up procedures.

Patients’ experience of CCE differs from colonoscopy.

Relevant information, shared decision making and support are required throughout the CCE process.

Information on the procedure may require rewriting to reflect the experiences of women.

Acceptance of CCE, including at home or primary care use, depends on addressing these needs and managing expectations about potential follow-up procedures.