Nationwide Variability of Colonoscopy Preparation Instructions

Ton, Loc; Lee, Helen; Taunk, Pushpak; Calderwood, Audrey H.; Jacobson, Brian C.

doi:10.1007/s10620-014-3262-8

Cited by 17 publications

(13 citation statements)

References 16 publications

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“…Recent systematic reviews found that patient education interventions improve the quality of bowel preparation [7] and reduce anxiety about the procedure [8]. Clinical practices use a range of different materials to inform patients about colonoscopy preparation [9], but there has been limited evaluation of the quality of the materials used and limited efforts to improve the quality of these materials.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Information Quality of Revised Patient Education Information on Colonoscopy: It Is New But Is It Improved?

et al. 2019

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Background Previous research indicates that patients and their families have many questions about colonoscopy that are not fully answered by existing resources. We developed revised forms on colonoscopy bowel preparation and on the procedure itself. Objective As the goal of the revised materials is to have improved information relative to currently available information, we were interested in how revised information compared with what is currently available in terms of information quality and patient preference. Methods Participants were asked to review one at a time the Revised and Current versions of Colonoscopy bowel preparation instructions (study 1) and About Colonoscopy (study 2). The order of administration of the Revised and Current versions was randomly counterbalanced to assess order effects . Respondents rated each form along the following dimensions: amount, clarity, trustworthiness, readability and understandability, how new or familiar the information was, and reassurance. Participants were asked which form they preferred and 4 questions about why they preferred it. Open-ended questions asked participants to describe likes and dislikes of the forms and suggestions for improvement. Results The study 1 and study 2 samples were similar. Overall, in study 1, 62.4% preferred the Revised form, 28.1% preferred the Current form, and 6.7% were not sure. Overall, in study 2, 50.5% preferred the Revised form, 31.1% preferred the Current form, and 18.4% were not sure. Almost 75% of those in study 1 who received the Revised form first, preferred it, compared with less than half of those who received it first in study 2. In study 1, 75% of those without previous colonoscopy experience preferred the Revised form, compared with more than half of those who had previously undergone a colonoscopy. The study 1 logistic regression analysis demonstrated that participants were more likely to prefer the Revised form if they had viewed it first and had no previous experience with colonoscopy. In study 2, none of the variables assessed were associated with a preference for the Revised form. In comparing the 2 forms head-to-head, participants who preferred the Revised form in study 1 rated it as clearer compared with those who preferred the Current form. Finally, many participants who preferred the Revised form indicated in the open-ended questions that they liked it because it had more information than the Current form and that it had good visual information. Conclusions This study is one of the first to evaluate 2 different patient education resources in a head-to-head comparison using the same participants in a within-subjects design. This approach was useful in comparing revised educational information with current resources. Moving forward, this knowledge translation approach of a head-to-head comparison of 2 d...

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Section: Introductionmentioning

confidence: 99%

Evaluating Information Quality of Revised Patient Education Information on Colonoscopy: It Is New But Is It Improved?

et al. 2019

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“…A recent recommendation from the US Multi-Society Taskforce on Colorectal Cancer recommended that all patients receive both oral and written instructions before colonoscopy but did not specify how or when these instructions should be delivered [ 13 ]. With this lack of standardization, endoscopy centers often develop educational materials and processes locally, resulting in significant variation in the instructional content of written bowel preparation instructions [ 14 ]. In this context, the aim of this systematic review is to evaluate the efficacy of patient education interventions on the quality of bowel preparation among adults undergoing colonoscopy in prospective, controlled studies.…”

Section: Introductionmentioning

confidence: 99%

How Efficacious Are Patient Education Interventions to Improve Bowel Preparation for Colonoscopy? A Systematic Review

et al. 2016

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BackgroundBowel preparation is inadequate in a large proportion of colonoscopies, leading to multiple clinical and economic harms. While most patients receive some form of education before colonoscopy, there is no consensus on the best approach.AimsThis systematic review aimed to evaluate the efficacy of patient education interventions to improve bowel preparation.MethodsWe searched the Cochrane Database, CINAHL, EMBASE, Ovid, and Web of Science. Inclusion criteria were: (1) a patient education intervention; (2) a primary aim of improving bowel preparation; (3) a validated bowel preparation scale; (4) a prospective design; (5) a concurrent control group; and, (6) adult participants. Study validity was assessed using a modified Downs and Black scale.Results1,080 abstracts were screened. Seven full text studies met inclusion criteria, including 2,660 patients. These studies evaluated multiple delivery platforms, including paper-based interventions (three studies), videos (two studies), re-education telephone calls the day before colonoscopy (one study), and in-person education by physicians (one study). Bowel preparation significantly improved with the intervention in all but one study. All but one study were done in a single center. Validity scores ranged from 13 to 24 (maximum 27). Four of five abstracts and research letters that met inclusion criteria also showed improvements in bowel preparation. Statistical and clinical heterogeneity precluded meta-analysis.ConclusionCompared to usual care, patient education interventions appear efficacious in improving the quality of bowel preparation. However, because of the small scale of the studies and individualized nature of the interventions, results of these studies may not be generalizable to other settings. Healthcare practices should consider systematically evaluating their current bowel preparation education methods before undertaking new interventions.

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“…We know that significant variation still exists across the country in terms of bowel preparation instructions, including types of purgatives prescribed, use of split-dose versus single-dose preparations, dietary restrictions, and medication instructions. 7 However, there are some concrete suggestions that practices can take if they find their patients' bowel preparation adequacy rates falling below the suggested 85% benchmark. First, changing to split-dosing of the bowel purgative is an absolute must in 2016.…”

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confidence: 99%

Enhancing bowel preparation instructions: Is the bang worth the buck,∗ or are we stuck with the muck?

MacArthur

Leszczynski

Jacobson

2017

Gastrointestinal Endoscopy

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Nationwide Variability of Colonoscopy Preparation Instructions

Cited by 17 publications

References 16 publications

Evaluating Information Quality of Revised Patient Education Information on Colonoscopy: It Is New But Is It Improved?

Evaluating Information Quality of Revised Patient Education Information on Colonoscopy: It Is New But Is It Improved?

How Efficacious Are Patient Education Interventions to Improve Bowel Preparation for Colonoscopy? A Systematic Review

Enhancing bowel preparation instructions: Is the bang worth the buck,∗ or are we stuck with the muck?

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