Patient educational video to enhance patient decision satisfaction for the treatment of pelvic organ prolapse

To assess if a pre-visit educational video designed to help patients better understand pelvic organ prolapse (POP) improves patient satisfaction with their management decision, POP knowledge, and physician ease of counseling. This is a prospective, physician-blinded, randomized controlled trial. Thirty-seven participants with symptoms of POP were enrolled and assigned to receive an electronically-administered 9-minute educational video or no video (control group). Those assigned to the video were invited to watch it prior to their initial visit. Eligibility criteria included women ≥18 years old presenting for an initial evaluation of POP. Exclusion criteria were a history of prior POP therapy, currently pregnant, presence of a cognitive disability, inability to speak English, and lack of access to the internet. All participants completed a baseline survey that included demographic information and the Prolapse and Incontinence Knowledge–POP Questionnaire (PIKQ-POP). The PIKQ-POP is a 12-question survey validated to assess patient knowledge of POP where higher scores represent greater knowledge. Patients also graded their level of knowledge on a 5-point scale with higher scores representing greater knowledge. After the initial visit patients completed the Satisfaction with Decision Scale for Pelvic Floor Disorders (SDS-PFD), a 6-question survey to assess satisfaction with a treatment decision where higher scores represent greater satisfaction. Patients also completed the PIKQ-POP and graded their knowledge. The counseling physician completed a 3-question survey after the visit to assess their perception of patient comprehension and ease of counseling. Clinical information was extracted from the medical record. Thirty-seven patients completed the study; 18 were randomized to the video and 19 to the control group. The mean age of patients was 56.7 years (SD: ±14.6), 78.4% were multiparous, and 67.6% were overweight or obese. Most patients were postmenopausal (56.8%) and had stage 2 POP (65.9%). There were no baseline differences between groups. Treatment selection included: 10 (27.0%) expectant management, 7 (18.9%) pelvic floor physical therapy, 8 (21.6%) pessary, 12 (32.4%) surgery, 4 (10.8%) undecided. There were no differences between groups. After the initial visit, there was no difference in the mean SDS-PFD scores between the video and control groups (4.89 vs. 4.78, p=0.32). The difference in the mean change in PIKQ-POP scores from baseline to after the initial visit was greater in the video than control group (11.43 vs. 10.20, p<0.05). The mean change in patient perception of POP knowledge was also greater in the video versus the control group (4.70 vs. 4.28, p<0.05). There was no difference in physician ease of counseling or perception of patient comprehension. While patient educational videos can be a useful tool to improve patient understanding of POP, their impact on patient satisfaction and physician counseling is less clear.