EVALUATION OF THE AT-HOME CAPSULE ENDOSCOPY (ACE) SERVICE AT UCLH: PRELIMINARY FINDINGS

ABSTRACT

Introduction UCLH has developed a modified 'At Home' Capsule endoscopy (ACE) service for patients undergoing capsule endoscopy where the entire procedure is completed at home through remote (telemedicine) assistance. This aimed to improve access to endoscopy services during the covid-19 pandemic. This a preliminary review of the ACE focusing on procedure safety, success rates and patient satisfaction. Methods Data on all ACE procedures at UCLH was looked at prospectively. Demographics, completion rates, and complication rates were recorded. All patients were asked to complete patient satisfaction questionnaires relating to the at home process (experience of the process, support from staff, expectations, tolerance of procedure, satisfaction, and preference for future investigations). Results 34 ACE procedures were looked at for this study. 13 were colon capsule endoscopies (CCE) and 21 small bowel capsule endoscopies (SBCE). Mean age of participants was 38 years and 17 (50%) were males. Indications were FIT positive (2.9%), iron-deficiency anaemia (14.7%), inflammatory bowel disease (61.7%) or investigation of other symptoms (20.6%). 31 (91.1%) procedures were successful- defined as a complete procedure with adequate bowel preparation. There were 3 failed ACEs (2= poor prep, 1= capsule not excreted). There were no complications and no need to convert the remote test to 'in-hospital'. 16 (47%) patient satisfaction questionnaires were returned. No patients found the procedure painful or embarrassing and 12 (75%) patients were not anxious prior to their procedure. On a satisfaction scale of 1-10, 12 patients (75%) scored ACE as ≥8. 13 (81.3%) patients would choose to have ACE vs inhospital CE. 12 (75%) patients would choose ACE as their preferred colonic investigation over CE in-hospital, colonoscopy, and CT colonography. Importantly, 87.5% of those patients had previously undergone a colonoscopy. Conclusions This is preliminary data on ACE, which shows a similar safety and success rate to standard practice in-hospital capsule endoscopy. 75% of patients preferred ACE over any other colonic investigation, suggesting potential increased acceptance by the public as a colorectal cancer screening test.