“You just put your life in their hands.” Patient experiences of ERCP: a qualitative interview study

Objective Endoscopic retrograde cholangiopancreatography (ERCP) is a high-risk endoscopic procedure. Despite service standards highlighting the importance of collecting feedback from patients, little is known about patient experiences of ERCP. This qualitative study addressed this evidence gap and sought to identify potential areas for improvement. Method Individuals ≥18 years old who had undergone ERCP at a tertiary centre in North East England were invited to participate in semistructured telephone interviews. Interviews were audio-recorded, pseudo-anonymised and transcribed verbatim. Thematic analysis was undertaken. Recruitment continued until no new data emerged that challenged analysis (n=19). Results Three overarching themes were developed. Communication: Participants’ experiences of communication varied, particularly regarding preprocedure and postprocedure information and risks of the procedure. Although most felt well-informed at the time of the procedure, on reflection some did not fully understand the severity of the procedure and complications. Experiential nature of ERCP: Participants described a mismatch between their expectations of sedation and their actual experiences. Although most anticipated feeling relaxed, some awoke with no memory of the procedure, whilst others remained fully alert throughout, describing this as unexpectedly distressing. Trust, apprehension and vulnerability: Some participants were nervous about the procedure and outcomes, whereas others placed full trust in clinicians. Some discussed feeling vulnerable during the procedure, particularly in relation to administration of the suppository. Conclusion Patients’ experiences of ERCP are shaped by the quality, clarity and timing of communication, as well as feelings of trust and vulnerability. Many issues raised by participants appear easily addressable with more comprehensive, earlier information.