1025 Further Validation of a Novel Patient Educational Booklet to Enhance Colonoscopy Preparation: Benefits in Single-Dose, but Not Split-Dose Preparations

Lee, Aaron; Vu, Michelle; Fisher, Deborah A.; Modi, Rushabh; Baek, Michael D.; Johnson, Marcus R.; Spiegel, Brennan M.

doi:10.1016/s0016-5085(13)60672-1

Cited by 6 publications

(2 citation statements)

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“…Third, along the same lines, future studies should systematically assess patient adherence to the bowel preparation, in addition to the education intervention, which will provide further support for efficacy. Fourth, while all three of the studies that used split-dose bowel preparation showed significant effects, others have suggested that educational interventions may not be as efficacious with split dosing [ 53 ] (NB: This study used the same brochure as Spiegel, et al and was published only in abstract form, not meeting criteria for inclusion in this review). Split-dose bowel preparation, which has become standard of care, should be used in future studies of educational interventions.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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“…While the tested measures did not result in an improvement of the quality of bowel preparations, it could be argued that standard care (that included split preparation and a simplified, easy-to-read, instructional booklet with pictorial guidance) caused a “ceiling effect.” Indeed, this is corroborated by Lee et al [24, 25] who showed a significant improvement in preparation quality in patients on single-dose preparation after developing a novel education booklet versus usual instructions, but this improvement effect was lost when the booklet was tested in a study with split-preparation cohorts with a higher baseline. Whilst giving the patients information is imperative for their understanding and engagement, too much information, or information overload, may have caused them to feel overwhelmed.…”

Section: Discussion/conclusionmentioning

confidence: 55%

Improving the Quality of Bowel Preparation: Rewarding Patients for Success or Intensive Patient Education?

Kutyla

Gray

Hippel

et al. 2020

Dig Dis

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Introduction and Objectives: The quality of the bowel preparation is a critical parameter for the outcome of colonoscopies. It is well established that the bowel preparation modality (e.g., split or larger volume preparation) significantly improves the quality of the bowel preparation. Patient compliance is another important factor impacting on the quality of bowel preparations that receives relatively little research attention. We aimed to explore if intensified education or a lottery ticket as reward for good bowel preparation could improve outcomes. Methods: After informed consent, all patients received a standardized printed information booklet. In a randomized fashion, patients were offered (a) a lottery scratchy ticket with an opportunity to win $25,000 as “reward” for good bowel preparation, (b) an education session delivered over the phone by a trained nurse, or (c) no additional measure. Results: Overall, the quality of the bowel preparation was rated good or very good in 69.1% (95% CI 61.7–75.7%) of patients. Reward intervention did not influence the quality of bowel preparation (OR 0.42, 95% CI 0.09–1.91, p = 0.260); however, bowel preparation quality decreased in patients randomized to receive the additional education (OR 0.28, 95% CI 0.08–0.96, p = 0.042). Neither intervention significantly impacted on polyp detection rates. Conclusions: Contrasting general beliefs, additional interventions (e.g., incentives or phone consultation) did not improve the quality of the bowel preparation. The unexpected result shows that utilizing extra resources must be balanced against real-world outcomes and may not always provide the expected result.

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Quality in Colonoscopy

Brunner

Calderwood

2015

Curr Gastroenterol Rep

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Quality metrics in colonoscopy are a growing area of focus given the development of and need for associated reporting and potential financial penalties. Three areas specifically have been identified as important by a multi-society task force, and the evidence behind each has been presented here. These metrics are adenoma detection rate, appropriate screening interval, and cecal intubation rate. Additional factors of interest include bowel preparation cleanliness and endoscope withdrawal time. Multifaceted interventions have been implemented to improve outcomes in colonoscopy with mixed success. Given that there are some quality metrics that have been shown to impact colorectal cancer outcomes, additional research should focus on disseminating these methods in a consistent and effective way across a myriad of practice models and patient populations.

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1025 Further Validation of a Novel Patient Educational Booklet to Enhance Colonoscopy Preparation: Benefits in Single-Dose, but Not Split-Dose Preparations

Cited by 6 publications

References 0 publications

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

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

Improving the Quality of Bowel Preparation: Rewarding Patients for Success or Intensive Patient Education?

Quality in Colonoscopy

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