In-Person Versus Video Preoperative Visit: A Randomized Clinical Trial

Abstract

Importance This study further supports virtual visits for gynecologic preoperative care.Objectives The objective of this study was to determine if preoperative video visits are noninferior to in-person visits in pelvic reconstructive surgery. Secondary objectives are as follows: patient satisfaction, convenience, visit duration, total perioperative visits, and patient travel time/distance. Study Design Noninferiority randomized-controlled trial of patients undergoing pelvic reconstructive surgery randomized to in-person or video counseling. The primary outcome was a composite score on the Preoperative Preparedness Questionnaire. Results Demographics were similar except for higher body mass index (BMI) in the video group (29.5 vs 26.3; P = 0.01), and fewer patients in the video group used text messaging for health care delivery (40.7% vs 59.3%, P = 0.04). Video visits were noninferior to in-person visits in Preoperative Preparedness Questionnaire scores (62.5 ± 4.6 vs 63.0 ± 3.6; difference = 0.5; 95% confidence interval, −0.8, □). There was no difference in "strongly agree" response to question 11, "Overall, I feel prepared for my upcoming surgery" (79.6% vs 88.9%, P = 0.19). Satisfaction was higher for video visits based on composite Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey scores (31.3 ± 1.5 vs 30.5 ± 2, P = 0.02). Video visits were more convenient (100% vs 85.2%, P < 0.01), of shorter duration for patients (39.3 ± 14.0 minutes vs 55.9 ± 18.9 minutes; P < 0.01), and similar length for health care providers (28.8 ± 9.6 minutes vs 28.2 ± 9.8 minutes; P = 0.77). The video visit group had fewer office visits (2.0 vs 3.0, P < 0.01) and traveled 66 minutes (P < 0.01) and 28 miles (P < 0.01) less. Conclusion Preoperative video visits are noninferior to in-person visits for preparing patients for pelvic reconstructive surgery.

Perioperative visits in minimally invasive gynecologic surgery

“…In several small RCTs, there was no difference in patient satisfaction between virtual and in-person visits for gynecologic surgical offices [7,8 ▪ ]. A 2023 noninferiority RCT of office compared with video preoperative visits found that patient reported greater convenience and satisfaction with video preoperative visits [9 ▪▪ ]. Although video visits were of shorter duration for patients, they were of the same duration for providers.…”