Development and Testing of an Automated 4-Day Text Messaging Guidance as an Aid for Improving Colonoscopy Preparation

Abstract

BackgroundIn gastroenterology a sufficient colon cleansing improves adenoma detection rate and prevents the need for preterm repeat colonoscopies due to invalid preparation. It has been shown that patient education is of major importance for improvement of colon cleansing.ObjectiveObjective of this study was to assess the function of an automated text messaging (short message service, SMS)–supported colonoscopy preparation starting 4 days before colonoscopy appointment.MethodsAfter preevaluation to assess mobile phone usage in the patient population for relevance of this approach, a Web-based, automated SMS text messaging system was developed, following which a single-center feasibility study at a tertiary care center was performed. Patients scheduled for outpatient colonoscopy were invited to participate. Patients enrolled in the study group received automated information about dietary recommendations and bowel cleansing during colonoscopy preparation. Data of outpatient colonoscopies with regular preparation procedure were used for pair matching and served as control. Primary end point was feasibility of SMS text messaging support in colonoscopy preparation assessed as stable and satisfactory function of the system. Secondary end points were quality of bowel preparation according to the Boston Bowel Preparation Scale (BBPS) and patient satisfaction with SMS text messaging–provided information assessed by a questionnaire.ResultsWeb-based SMS text messaging–supported colonoscopy preparation was successful and feasible in 19 of 20 patients. Mean (standard error of the mean, SEM) total BBPS score was slightly higher in the SMS group than in the control group (7.3, SEM 0.3 vs 6.4, SEM 0.2) and for each colonic region (left, transverse, and right colon). Patient satisfaction regarding SMS text messaging–based information was high.ConclusionsUsing SMS for colonoscopy preparation with 4 days’ guidance including dietary recommendation is a new approach to improve colonoscopy preparation. Quality of colonoscopy preparation was sufficient and patients were highly satisfied with the system during colonoscopy preparation.

Text Messaging Interventions on Cancer Screening Rates: A Systematic Review

“…Colonoscopy is even more complicated, as it requires patients to restrict their diet for several days, drink a large volume of fluids for bowel preparation, and finally undergo an invasive examination. A few trials have studied the impact of text messaging on the quality of bowel preparation, but none has measured the effect of bowel preparation instructions via SMS on screening rates themselves [ 25 , 26 ]. If the problem lies with a higher barrier to overcome for colorectal versus breast and cervical cancer screening, then the strategies used in some included studies may help to maximize the effect of SMS.…”

A Smartphone App for Improvement of Colonoscopy Preparation (ColoprAPP): Development and Feasibility Study

“…Education and continuous guidance of patients has been shown to ensure quality of colonoscopy preparation and patient compliance. Numerous approaches using additional booklets, cartoons, educational videos, and text messaging have shown a direct benefit [ 5 - 8 ]. Nevertheless, all approaches still have their specific limitations toward the availability of the medium.…”

Enhanced education for bowel preparation before colonoscopy: A state‐of‐the‐art review

“…The educational intervention led to a lower OBPS in the SMS group than that in the no‐SMS group. Another study in Germany also investigated the use of an automated SMS reminder system started 4 days before the colonoscopy procedure and covered the whole crucial process of BP (Table ). The SMS gave similar information to that in paper‐based instructions.…”

“…The first comprises counseling sessions, educational booklets, cartoon visual aids and educational videos, which have the main advantage of promoting patients’ comprehension of BP. The second category, including the short message service (SMS) and telephone, has the main advantages of reminding the patients. The third contains a smart phone application (app), which makes instructions easily accessible (Table ).…”