ARTICLE
October 12, 2018

Reduce Aborted Scans in MRI; A Non-Pharmacological Approach

Approximately 2 million MRI procedures cannot be completed worldwide due to patient anxiety disorders or claustrophobia. With an average reimbursement of $500 (U.S.) per MRI scan, this is equal to $1 billion in lost productivity. On average, 2.3% of patients scheduled for MR imaging suffer from claustrophobia.

If a patient is claustrophobic or highly anxious, the technologist may need to coach the patient through their exam, give anti-anxiety medications, or as mentioned above, abort the exam because the patient is unable to complete it.

Patient Fear of MRI

While some patients only experience one or a few MRI’s in their lifetime, many become a “frequent flyer” in the MRI suite to monitor a chronic illness or injury.

It is understandable the fears a first-timer may experience, but one would suspect it would be easier to tolerate for the patient that needs to go frequently. However, it does not appear, based on feedback on MRI message boards, that MRI’s get easier for everyone with more experience and mileage in the bore.

Message Boards - Where Patients Share Their MRI Experience

On the message board msworld.org, patients share their experience and fears when getting an MRI. Reading these types of boards gives insight as to what patients experience and the fear they have before going to the exam and afterwards.

“I was never claustrophobic until after my first MRI (which didn't even bother me at the time.) Now, I have to be almost totally knocked out with 1 1/2 Xanax before I'll get anywhere near that machine. (And with that many Xanax, I run the risk of sitting in the waiting area babbling about bunnies smoking cigarettes and the need for putting kittens into bigger skins so they'll grow.)”

“My fear starts the minute they strap my head in place and lock that hood on my head. We have open MRI's here but they still get me all sweaty just thinking of them. To add insult to injury, I can't take any form of a tranquilizer, as I have a reverse reaction to them." 

“(I) Take a Xanax before I go also. One time, I took 2, but then a fell asleep and snored, so they had to do it again. That just added to the ordeal, so now I am at one, (and take) about 1 hr. before I go. I get designated driver to drive me, so I am able to take them. If I had to drive myself, I am not sure what I would do”.

“The mention of an MRI sets me into a panic attack. I have one coming up at the end of the year and I am already having nightmares about it! I was never claustrophobic until I had to go through it for MS, now.... well let's just say we avoid all small spaces! It has gotten worse over time. For the next one however, I am going to be put to sleep. Maybe, just maybe, I will make it through all the way without making them stop every two minutes”!

faces of anxiety and fear

The downside of pharmaceuticals used in MRI

In July of 2014, The Joint Commission added to its safety requirements for MRI that facilities have strategies in place for calming or responding to the anxious or distressed patient, including where, when, and how medications for anxiety are to be handled.

Xanax, as you've read above, is a commonly prescribed medication used to reduce anxiety in MRI that falls under a class of drugs known as benzodiazepines.

According to American Addiction Centers, benzodiazepines can have a user hooked in weeks. Many thousands seek treatment every year for dependencies on this drug. In an article titled The Benefits and Risks of Benzodiazepines, side effects of benzodiazepines can include dizziness, drowsiness, poor coordination, and feelings of depression.

With the national push to reduce pharmaceutical use, MRI providers, like all healthcare providers, may be feeling the pressure to offer an alternative, non-pharmacological, option to help their patients get through their exam.

Increased satisfaction with a non-pharmacological solutionElequil aromatabs

Elequil aromatabs®, aromatherapy designed for the clinical setting, was specifically invented to help patients get through their MRI and has proven creditable since its launch in 2010.

Patients continue to share with us on how Elequil® has positively impacted their MRI experience.

“The aromatabs are a life saver. I was trampled 5 years ago at a sporting event and have been unable to complete an MRI ever since due to my anxiousness and fear of tight spaces. I was sitting in the room waiting, losing my mind because I forgot my Valium when I saw the sign about aromatabs. The tech gave me one and it made a world of difference and I was finally able to complete my first MRI in 5 years. Thanks.” 

“I recently completed over two hours of MRI / MRA testing. The technician attached a Lavender Sandalwood Elequil aromatab to my gown as he prepared the MRI equipment. During the testing I noticed a subtle scent that helped me relax but I didn't know where it was coming from. The technician later explained that he used an Elequil aromatab. I'm amazed such a small thing can make such a significant difference."

“I was given the lavender aromatab to help me get through an MRI at the Hospital for Special Surgery in NY. What a great idea to use aromatherapy for an MRI! Really helped. Loved the tab so much I wore it all day! I would be so glad to have some more for use at home when just relaxing with a cup of tea - great to have a little aromatherapy at home, too!"

“I recently had my first MRI at Diagnostic Imaging. I was initially very anxious when I was entering the open MRI. The tech had to bring me out and offered the lavender tab and I was calmed instantly and was able to complete the 20 minute MRI without further incident. I am a true believer in this product!”

“I was first given a tab to use by the Radiology Dept at the Mt. Kisco Medical Group in Westchester County NY. I was scheduled for a battery of tests including MRI's and MRA's and was very anxious both because of my diagnosis and the actual testing. I was given the lavender/sandalwood tab and initially was not very optimistic re its impact…I was wrong!! The scent is so soothing and calming and somehow managed to calm me during the procedure. I asked the staff who were kind enough to give me an extra one that I wore the day of my surgery! It helped me enough that I did not have to take Ativan or Valium or any other agent during the testing process. I highly recommend trying this product…I think of it as a calming agent that you don’t have to drink or take in pill form! I am also a retired Physician Assistant who worked 30 years in Psychiatry and plan to return to work part time after my medical issues resolve. I will most likely use this product on my anxious patients and I feel very hopeful regarding its results. Congrats to the developers of this tab…you succeeded!!”

“I have been going through many diagnostic tests in the last two weeks and I noticed a great offering when I was going into the MRI - the scent tabs. I chose the calming lavender. It was wonderful-very soothing. I felt that this additional help was so good I asked the nurse where I could get them! She wrote the name of the company and I called. The aromatabs were that good! I looked them up online but it was a Friday. I asked for the scent tab at my next MRI. I called today after using them under my pillow that night. I was thinking I wish I had access to a box of them! I knew many others that would probably feel the same way! The positive effects of aromatherapy are so well-known and this simple tab is so convenient! I hope these can be made available for everyone to use whenever and wherever they would like to enjoy a calming inhalation of lavender. Excellent product!”

Elequil's impact on procedure cancellations:

Six healthcare facilities participated in a 4 week study where all patients scheduled for an MRI were to be included. Scans at all facilities during weeks 1 and 3 were performed without aromatherapy. Scans at all facilities during weeks 2 and 4 were performed with aromatherapy in the form of a lavender-sandalwood Elequil aromatabs® for each patient.

A total of 1,086 patients were enrolled in the study: 588 in the control group (C) and 498 in the aromatherapy group (AT). The results proved a reduction in the percent of MRI scans due to anxiety and claustrophobia. Coaching time was also reduced.

Table Diagram

 

 

 

One can extrapolate these benefits translating to increased patient satisfaction and substantial financial reward over the course of a year.

When an MRI exam is not completed, the patient has to come back (if they show up at all) and that delays diagnosis, the patient may have taken time off from work (which now equates to lost time) and they have to now take more time off for the next appointment. The patient may have to get a prescription from their doctor as well as get someone to drive them to the appointment. All of which can negatively impact the patient experience.

Then there is a loss of hospital revenue. In the study "The Financial Burden of Missed Appointments: Uncaptured Revenue Due to Outpatient No-Shows in Radiology," missed appointments for brain MRI’s equated to $211,500 in lost revenue from Medicare & private insurer payments.  More commonly, the aborted scan is also lost revenue.

The table below illustrates how using Elequil on every patient based on the study results, can result in a total reimbursement gain in the MRI department of $25,000 after investing in Elequil.

Table Diagram

 

 

 

 

 

 

 

Of course, there is no greater proof of the impact Elequil has had on patients being able to complete their MRI exams than hearing from your peers:

 “We have used Elequil aromatabs at our facility for 4 years. We have almost eliminated our loss of scan due to uneasy feelings from being in an MRI. Our patients are thrilled with the product.”

— MRI Manager, SportsMED Orthopaedic Surgery & Spine CenterHuntsville, AL

“Elequil aromatabs have been very beneficial for fretful patients during Breast Interventional Procedures and for the MRI patients. The biopsy patients are more relaxed and we are experiencing fewer cancellations.”

— Mammography Quality Control Coordinator Jefferson Radiology, Farmington, CT

How Elequil® differs from other aromatherapy methods:

Elequil for pain managementAromatherapy as an alternative holistic intervention is not new, however, current methods including oils applied to cotton balls and diffusers can be hazardous, messy to use, and subject to inconsistencies. As a result, the desired impact can vary from day to day and patient to patient. Elequil® is most often the preferred method in the clinical setting for the following reasons:

100% pure essential oils. This means Elequil is unadulterated with no pesticides or synthetics.

Unique controlled delivery system: Consistent amount of oils makes Elequil perfect for clinical studies and for use in system-wide initiatives. The tab adheres to gown/clothing for individual use and perfect for patients incapable of holding a product or who have impaired motor skills. Minimum/Maximum tear notch allows customization of scent based on need and preference.

Metal/foil-free. Elequil is acceptable for use in OR, MRI, and anywhere else where metal/foil is contraindicated.

Experience Elequil for yourself

Email info@beekley.com to evaluate Elequil's impact on the patient experience in your MRI suite. Patient and/or staff surveys are available upon request to gauge how effective aromatherapy can be as a non-pharmacological approach.

You can also visit www.elequil.com for more information.

Related Articles:

Can Inhalation Aromatherapy Reduce Aborted MRI Scans in Patients with Anxiety and Claustrophobia?

A Simple Way to "Wow" Your Patients without Compromising Quality Care 

The Patient Experience, The Limbic System, and You 

Melissa Vibberts
Sr. Product Manager
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