Impact of patient audiovisual re-education via a smartphone on the quality of bowel preparation before colonoscopy: a single-blinded randomized study

Back, Su Young; Kim, Hyun Gun; Ahn, Eu Mi; Park, Suyeon; Jeon, Seong Ran; Im, Hee Hyuk; Kim, Jin–Oh; Ko, Bong Min; Lee, Joon Seong; Lee, Tae Hee; Cho, Jun-Hyung

doi:10.1016/j.gie.2017.09.007

Cited by 56 publications

(71 citation statements)

References 19 publications

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“…With the wide use of the internet and smartphones, new online educational methods have become increasingly favoured. Some studies (Back et al, ; Kang et al, ) discussed the effect of internet‐based education on patient compliance and the quality of bowel preparation and showed consistent results with our study. Mobile apps have unique advantages compared with traditional methods.…”

Section: Discussionsupporting

confidence: 91%

Improving the quality of bowel preparation through an app for inpatients undergoing colonoscopy: A randomized controlled trial

Guo

Zuo

et al. 2020

Journal of Advanced Nursing

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Aims To explore whether educational information delivered via a medical smartphone app in conjunction with verbal and written instructions, compared with traditional booklet‐based and verbal instructions, could improve the quality of bowel preparation for hospitalized patients undergoing colonoscopy. Design A prospective, single‐blinded, randomized controlled trial. Methods We performed a prospective, endoscopist‐blinded, randomized, controlled trial at Qilu Hospital of Shandong University in China between October 2017–March 2018. Inpatients who are eligible, based on the inclusion criteria, were randomized into two groups. Both groups received oral and written instructions for bowel preparation. In addition, the smartphone app group received instructions through a medical smartphone app. The primary outcome was the rate of adequate bowel preparation according to the Boston bowel preparation scale score. The secondary outcomes included patient compliance with instructions on how to take laxatives, side effects and rates of adenoma detection. Results A total of 293 patients were enrolled in this study. Demographic characteristics were comparable between the two groups. The χ2 test showed that the medical smartphone app group showed significant improvement in the rate of adequate bowel preparation compared with the control group (77.2% vs. 56.8%, p < .001). The adenoma detection rate (ADR) was significantly higher in the smartphone app group than in the control group (21.4% vs. 12.8%, p = .029) based on the χ2 test. The rates of incomplete compliance with instructions were 15.17% in the smartphone app group and 33.11% in the control group (p < .001) based on the χ2 test. The overall adverse events were 23.45% and 37.84% in the smartphone app and control groups, respectively (p = .008), based on the χ2 test. Conclusion Instructions provided via a mobile social media app in conjunction with traditional verbal and written methods could improve the quality of bowel preparation, increase the ADR and decrease adverse effects. App instructions could be an effective addition to oral and written instructions for inpatients undergoing colonoscopy. Impact This study suggested that clinical personnel could deliver information via smartphone as a powerful addition to traditional educational methods that could improve work efficiency and help patients increase the success rate of bowel preparation. Trial registration: Chinese clinical trial registration number: ChiCTR1900024666.

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Section: Discussionsupporting

confidence: 91%

Improving the quality of bowel preparation through an app for inpatients undergoing colonoscopy: A randomized controlled trial

Guo

Zuo

et al. 2020

Journal of Advanced Nursing

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“…Of the remaining 30 articles, 12 were excluded after full-text reading for the following reasons: no BP quality as the primary or secondary outcomes (n = 2), non-RCTs (n = 5) and insufficient data (n = 5). Finally, 18 studies were included in this meta-analysis [11][12][13][14][15][16][17][18][19][20][21][22][23][24][29][30][31][32] (Fig 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Then, pictures [12], cartoon visual aids [13], booklets [14,15] and even videos [16] were applied. With the development of economy and technology and the popularization of digital devices, phone call [17,18], short message service [19,20], smart phone applications [21,22], social media [23] and online video [24] were employed to reinforce patients' education. However, the conclusions were inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Reinforced education improves the quality of bowel preparation for colonoscopy: An updated meta-analysis of randomized controlled trials

Guo

Wang

et al. 2020

PLoS ONE

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Background and aims Inadequate bowel preparation (BP) is an unfavorable factor that influence the success of colonoscopy. Although standard education (SE) given to patients are proved useful to avoid inadequate BP. Studies concerning the effects of reinforced education (RE) on the quality of BP were inconsistent. The aim of this updated meta-analysis of randomized controlled trial was to compare the quality of BP between patients receiving RE in addition to SE and those receiving SE alone. Methods MEDLINE, EMBASE, Web of Science and the Cochrane Library were systemically searched to identify the relevant studies published through April 2019. The primary outcome was the rate of adequate BP. Subgroup analyses were conducted. Secondary outcomes included BP score, adenoma detection rate (ADR), polyp detection rate (PDR), insertion time, withdrawal time, adverse events, >80% purgative intake and diet compliance. Dichotomous variables were reported as odds ratio (OR) with 95% confidence interval (CI). Continuous data were reported as mean difference (MD) with 95%CI. Pooled estimates of OR or MD were calculated using a random-effects model. Statistical heterogeneity was accessed by calculating the I2 value. A P value less than 0.05 was considered significant. Results A total of 18 randomized controlled trails (N = 6536) were included in this meta-analysis. Patients who received RE had a better BP quality than those only receiving SE (

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“…As a result, these interventions will be beneficial in underperforming units with scores well below the 85 % benchmark that has been advised by the US Multi-Society Task Force on Colorectal Cancer Screening [29]. In several recent (non-Western) studies that demonstrated improved bowel cleanliness by smartphone intervention, baseline scores in the control group were often below this point (73.6 % -77.2 %) [25,30]. By contrast, in our four trial units (already performing well above 90 % adequate bowel preparation in controls), the ceiling effect might have prevented the detection of any meaningful superiority difference.…”

Section: Discussionmentioning

confidence: 99%

Computer-based patient education is non-inferior to nurse counselling prior to colonoscopy: a multicenter randomized controlled trial

et al. 2020

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Background: Optimal patient education prior to colonoscopy improves adherence to instructions for bowel preparation and leads to cleaner colons. We developed computer based education (CBE) supported by video and 3D animations. We hypothesized that CBE replaces nurse counselling without losing quality of bowel preparation during colonoscopy. Methods: We conducted a prospective, multicenter, endoscopist blinded, non-inferiority randomized controlled trial. The primary outcome was adequate bowel preparation, evaluated using the Boston Bowel Preparation Scale (BBPS). Secondary outcome measures were sickness absence due to outpatient clinic visit, patient anxiety / satisfaction scores and information re-call. We included patients in four endoscopy units (rural, urban, and tertiary). Results: We screened 1035 eligible patients and randomized 845. After evaluation, 684 were included in the intention-to-treat (ITT) group. Subsequently, 497 patients were included in per-protocol (PP) analysis, 217 in nurse counselling and 280 in the CBE group. Baseline characteristics were similarly distributed among groups. In PP analysis, adequate bowel cleansing was achieved in 93.2 % (261/280) of CBE patients, which was non-inferior to nurse counselled patients (94%, 204/217), with a difference of -0.8% [95% CI [- 5.1; 3.5]%. Non-inferiority was confirmed in the ITT population. Sickness absence was significantly more frequent in nurse counselled patients (28.0% vs 4.8%). In CBE patients, 21.5% needed additional information, resulting in 3.0% extra outpatient visits. Conclusion: CBE is non-inferior to nurse counselling in terms of bowel preparation during colonoscopy, with lower patient sickness leave. CBE may serve as an efficient educational tool informing patients before colonoscopy in routine clinical practice.

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Impact of patient audiovisual re-education via a smartphone on the quality of bowel preparation before colonoscopy: a single-blinded randomized study

Cited by 56 publications

References 19 publications

Improving the quality of bowel preparation through an app for inpatients undergoing colonoscopy: A randomized controlled trial

Improving the quality of bowel preparation through an app for inpatients undergoing colonoscopy: A randomized controlled trial

Reinforced education improves the quality of bowel preparation for colonoscopy: An updated meta-analysis of randomized controlled trials

Computer-based patient education is non-inferior to nurse counselling prior to colonoscopy: a multicenter randomized controlled trial

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