title: Randomized trial of a web-based tool for prolapse: impact on patient understanding and provider counseling.
abstract: OBJECTIVE
  Effective patient/provider communication is important to ensure patient understanding, safety, and satisfaction. Our hypothesis was that interactive patient/provider counseling using a web-based tool (iPad application) would have a greater impact on patient satisfaction with understanding prolapse symptoms compared with standard counseling (SC).
  
  
  METHODS
  Women with complaints of seeing/sensing a vaginal bulge were enrolled in this randomized controlled trial. Participants completed pre- and postvisit Likert scale questionnaires on satisfaction with prolapse knowledge and related anxiety. After new patient histories and physical examinations, study participants were randomized to SC or SC with iPad. Ninety participants were required to detect a 30% difference in satisfaction with prolapse knowledge between the two groups.
  
  
  RESULTS
  Ninety women were randomized to SC (n = 44) or SC with iPad (n = 46). At baseline, 47% of women were satisfied with their understanding of bulge symptoms (50% SC vs. 43.5% SC with iPad, p = 0.5). After counseling, 97% of women reported increased satisfaction with understanding of bulge symptoms (p < 0.0001), with no difference between groups [42/44 (95.5%) SC vs. 45/46 (97.8%) SC with iPad, p = 0.5]. Baseline anxiety was high: 70% (65.9% SC vs. 73.9% SC with iPad, p = 0.4). After counseling, anxiety decreased to 30% (p < 0.0001), with improvement in both groups (31.8% SC vs. 28.3% SC with iPad™, p = 0.7). Counseling times were similar between groups (9.5 min., SC vs. 8.9 min., SC with iPad, p = 0.4).
  
  
  CONCLUSIONS
  Interactive counseling was associated with increased patient satisfaction with understanding bulge symptoms and decreased anxiety whether a web-based tool was used or not.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina, 3023 Old Clinic Building, Campus Box 7570, Chapel Hill, NC, 27599, USA, emmyers@med.unc.edu.
authors.forename: Erinn M
authors.initials: EM
authors.lastname: Myers
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Robinson
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Geller
authors.forename: Ellen
authors.initials: E
authors.lastname: Wells
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Matthews
authors.forename: Jacquia L
authors.initials: JL
authors.lastname: Fenderson
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Crane
authors.forename: Mary
authors.initials: M
authors.lastname: Jannelli
authors.forename: AnnaMarie
authors.initials: A
authors.lastname: Connolly
mesh_terms: D000368:Aged; D003142:Communication; D037001:Directive Counseling / Q000379:methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008875:Middle Aged; D063731:Mobile Applications; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000175:diagnosis*; D010817:Physician-Patient Relations; D013997:Time Factors