Vaginal pessaries: can an educational brochure help patients to better understand their care?

Aims and objectives: Pelvic organ prolapse is a common condition, with reported incidence of up to 50%. We aimed to assess whether written information, in addition to face-to-face consultation, improved happiness with information, confidence to self-manage and prolapse knowledge in women attending a pessary clinic. Background: Little is known about the effect of adding a written information brochure on clinical outcomes of patients using pessaries. Design: This prospective study used a pretest-posttest method, conducted following Ethical approval. Methods: Between February–December 2013, all women attending Pessary Clinic were eligible for participation. A questionnaire was developed to assess happiness with information, confidence regarding self-management (using a visual analogue scale, 1–10) and prolapse knowledge (using eight multiple-choice questions). Data were collected in person at baseline prior to distribution of a patient brochure and thereafter by telephone at one week and three months. Paired analysis was conducted using the McNemar test and related samples Wilcoxon signed-rank test for VAS items with p < 0.05 significant. Results: Sixty women were recruited. Fifty-eight completed all questionnaires. Improvement in happiness with information, confidence regarding self-management and knowledge scores occurred at one week (p < 0.05) and were maintained at three months (p < 0.05). Changes were unrelated to age (p > 0.05), education level (p > 0.05), first language (p > 0.05) or previous clinic visits (p > 0.05). Conclusion: A written information brochure, in addition to face-to-face consultation, improves happiness with information, confidence to self-manage and knowledge about pessaries compared to verbal instruction alone and helps patients better understand their care. The written brochure was equally effective in women with low education and advanced age, and occurred regardless of the number of clinic visits.