Hospital Senpai: A pilot for reducing health anxiety in inflammatory bowel disease patients using video testimonials (Preprint)

BACKGROUND Health anxiety has many damaging effects for chronic illness patients. Physicians are often unable to alleviate concerns related to living with a disease such as the impact on daily life, and unregulated websites can over-represent extreme anxiety-inducing outcomes. Video technology has shown some success in combining the effectiveness of personal interventions with the scalability of text-based materials, but it has not received sufficient attention. Furthermore, there has been limited work in assessing the efficacy of video technology for anxiety reduction outside the US. OBJECTIVE This pilot study assesses the efficacy of anxiety reduction for Crohn's disease (CD) and ulcerative colitis (UC) patients by showing patient testimonial videos during hospital visits. It investigates the degree to which patient testimonials can affect state anxiety, and whether patients are comfortable enough with the technology to share their stories. Patients' willingness to share is a critical component to scaling up this anxiety reduction approach. METHODS CD (n = 51) and UC (n = 49) patients were shown testimonial videos of CD patients during their physician consultations at Kitasato University Kitasato Institute Hospital (北里大学) in Japan. The video testimonials were collected from Dipex Japan, the Japan branch of an international organization specializing in understanding patient experiences. Videos were viewed using standard Lenovo Chromebooks and custom video-viewing software. Patients completed a Visual Analogue Scale for Anxiety (VAS-A) before and after viewing the videos, a Hospital Anxiety and Depression Scale (HADS) survey before the videos, and satisfaction surveys. Patients receiving infusion therapy participated in their study while receiving treatment to minimize hospital workflow disruption. RESULTS VAS-A anxiety reduction was significant in the entire cohort both when viewed as an ordinal variable (P=.003, T=1086.5) and as a continuous one (P=.013, t=-2.54, 90% CI [-3.47, -0.72]). 80% of patients with high HADS-A scores (n=15) and 71% of patients with high starting state anxiety (n=24) experienced reduced anxiety after watching testimonials. Patients with high state anxiety but low HADS-A scores experienced anxiety reduction (69%, n=16), and HADS-A was correlated with anxiety reduction mostly through baseline VAS-A score. 42% of patients responded that they would share their stories for future users. When UC patients received testimonials from CD patients, 71% reported they were relevant despite differences in condition. CONCLUSIONS The pilot results suggest that patient testimonial videos can reduce illness-related state anxiety for patients with CD and UC, especially in those with higher baseline state anxiety. This indicates that testimonial videos can benefit patients even if they don't have a formal anxiety disorder. The UC patients found the CD testimonials valuable, and nearly half of patients were willing to share their stories, suggesting that technology can help scale up efforts to record and share patient testimonials.