Patient autonomy in capsule endoscopy: problems and perspectives
DOI:
https://doi.org/10.31636/prmd.v8i2.3Keywords:
capsule endoscopy, patient autonomy, small bowel, NHSU, clinical guidelinesAbstract
Objective: To evaluate patient autonomy in choosing capsule endoscopy (CE) in Ukraine, compare access with European and US practice, justify immediate CE after negative EGD and colonoscopy in symptomatic patients, and provide policy proposals for implementation.
Methods: Policy review of Ukrainian MoH documents and NHSU packages; appraisal of ESGE, ACG, and ASGE guidelines for CE indications; comparative analysis of financing models; synthesis of an author’s series of >100 CE in patients with abdominal pain and negative EGD/colonoscopy.
Results: CE is certified in Ukraine but not integrated into NHSU-funded packages and constrained in private practice, reducing patient autonomy. In the EU and US, CE is included in protocols and allowed as both reimbursed and self-funded options. In the author’s >100-case series, clinically meaningful findings were present in over half of cases (diverticula, inflammatory lesions, helminthiasis, and others).
Conclusions: CE should be excluded from the category of “medical assistance” and included as a certified technology requiring no separate justification. This would enhance patient autonomy, align Ukrainian practice with international standards, and improve diagnostic yield in challenging cases.
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References
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This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License
