Use of an iPad™ application in preoperative counseling for pelvic reconstructive surgery: a randomized trial

• Published in: International Urogynecology Journal 2018-09, Vol.29 (9), p.1289-1295
• Main Authors: Kinman, Casey L., Meriwether, Kate V., Powell, Cayse M., Hobson, Deslyn T. G., Gaskins, Jeremy T., Francis, Sean L.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Counseling; Female; Gynecology; Humans; Informed consent; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient Education as Topic - methods; Patient Satisfaction; Pelvic Organ Prolapse - surgery; Preoperative Care - methods; Reconstructive surgery; Reconstructive Surgical Procedures - methods; Surgery; Treatment Outcome; Urology
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-017-3513-2

Introduction and hypothesis The goal of this study was to evaluate whether the addition of an iPad™ application to the informed consent process for pelvic organ prolapse (POP) surgery improves patient understanding and retention of information compared with standard verbal counseling (SVC) alone. Methods Patients scheduled for POP surgery were randomized to SVC alone or SVC augmented with an iPad™ application. Prior to counseling, immediately following counseling, and 6 weeks after surgery, patients completed a written quiz testing their understanding of POP and surgical repair (worst score 0; best score 20). Primary outcome was score change from pre- to immediately postcounseling. Secondary outcomes were patient satisfaction and score change from postcounseling to 6 weeks after surgery. Twenty-six patients per group were needed to detect a 2.8-point difference in score change between groups (80% power; α = 0.05). Results Sixty patients were randomized, and 57 patients (29 SVC; 28 iPad) were included in the final analysis. There was no significant difference in score change between groups immediately postcounseling. Six weeks after surgery, patients in the iPad group had more deterioration of score (iPad −4.0 ± 2.8 vs. SVC −0.6 ± 2.3 points; p  = 0.02). Both groups reported similar satisfaction with counseling. Conclusions The addition of a POP-based iPad™ application to the informed consent process for POP surgery did not improve patient comprehension immediately postcounseling and resulted in poorer retention of information 6 weeks after surgery compared with SVC alone.