Enhanced instructions improve the quality of bowel preparation for colonoscopy: a meta-analysis of randomized controlled trials

Guo, Xiaotong; Yang, Zhiping; Zhao, Lina; Leung, Felix W.; Luo, Hui; Kang, Xiaoyu; Li, Xin; Jia, Hui; Yang, Shengye; Qin, Tao; Pan, Yanglin; Guo, Xiaomao

doi:10.1016/j.gie.2016.05.012

Cited by 90 publications

(100 citation statements)

References 27 publications

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“…In addition, identification of patients who have failed previous bowel preparations is important in order to identify compliance issues and/or recommend a preparation with increased intensity. Table 4 lists specific evidence-based actions that can improve bowel preparation compliance 45 , and we have made an effort to implement all of these at our institution. MacArther et al have emphasized that there is no single intervention that is proven to be the most important for improving compliance, but rather practices should consider a number of different interventions that combined may be the most effective 46 .…”

Section: Methods For Improving Compliance and Outcomesmentioning

confidence: 99%

Optimal Bowel Cleansing for Colonoscopy in the Elderly Patient

Hovsepians

Gupta

2017

Drugs Aging

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Colonoscopy is an important diagnostic and screening tool for colorectal cancer detection and prevention, and adequate bowel preparation is critical for successful colonoscopy. Complications related to colonoscopy are increased in elderly patients, either directly or indirectly related to the procedure, and the risks and benefits of colonoscopy procedures need to be carefully considered in these patients. Recent studies have shown that the 4 liter polyethylene glycol with a split preparation is safe and effective for elderly patients, and is the preferred preparation for patients with medical comorbidites. Preparations containing sodium phosphate are generally not recommended for the elderly due to increased renal complications. In addition, a low residue diet may aid in tolerance and willingness to undergo the procedure compared with a clear liquid diet, with comparable bowel preparation adequacy. Risk factors for inadequate bowel preparations include poor adherence to split preparation instructions or volume of solution ingested, and certain patient related medications and comorbidities, such as diabetes, elevated body mass index, and antidepressant or narcotic use. Methods for achieving safe and adequate bowel preparations in the elderly include clear instructions, reminder calls, and case management for potential confounding patient related factors.

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Section: Methods For Improving Compliance and Outcomesmentioning

confidence: 99%

Optimal Bowel Cleansing for Colonoscopy in the Elderly Patient

Hovsepians

Gupta

2017

Drugs Aging

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“…In recent years, studies on interventions by multimedia and videos to improve bowel preparation for a colonoscopy have been extensively reported. Although some of these studies recorded positive effects, others did not . Therefore, the impact of video education on patients’ informed consent for ERCP remains to be explored.…”

Section: Introductionmentioning

confidence: 99%

Video education can improve awareness of risks for patients undergoing endoscopic retrograde cholangiopancreatography: A randomized trial

Xia

Zhu

Zeng

et al. 2019

J of Digest Diseases

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Objective: We conducted a randomized trial aiming at improving patients' informed consent for undergoing endoscopic retrograde cholangiopancreatography (ERCP) in clinical care by comparing the efficacy of an additional educational video to written informed consent with that of written informed consent alone.Methods: This was a single-center, randomized controlled trial. Consecutive patients undergoing ERCP were randomized to a video education or a control group. An educational video detailing ERCP procedure plus standard written informed consent was administered to the video education group, while the control group reviewed standard written informed consent only. The primary outcome was the patients' perception of the risk or possibility of ERCP complications. Their perception of the benefits of ERCP, alternative treatments and overall satisfaction with the process of informed consent were also compared. Results:In total 205 patients were included in the study (104 in the control group and 101 in the video education group). Patients' comprehension of ERCP-related complications in the video education group was significantly increased (P < 0.001), and these patients were more likely to correctly identify the incidence of such complications. Significantly more patients in the video education group were very satisfied with informed consent process (87.1% vs 76.0%, P = 0.040) and fewer patients needed additional explanations (31.7% vs 47.1%, P = 0.024).Conclusions: A supplementary educational video could greatly improve patient's understanding of ERCP procedure, in particular, its potential risks and complications, as well as their overall satisfaction with the process of informed consent (ClinicalTrials.gov no. NCT02810379). K E Y W O R D Seducation, endoscopic retrograde cholangiopancreatography, informed consent, video † These authors contributed equally to this work.

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“…Besides, the requirements of BP are often complex and difficult for patients to comprehend and memorize, especially those with risk factors for poor compliance. As a result, the routine patient education delivered by a nurse through the form of verbal and written instructions which include simple information about BP have been proven to be inadequate for BP . Additionally, the contents on patient education in the newest BP guidelines in America and Europe need to be updated as they do not incorporate the latest studies and specific recommendations for enhanced BP education …”

Section: Introductionmentioning

confidence: 99%

“…Recently, various educational interventions have been developed to improve preparation quality. They can be divided into three broad categories . The first comprises counseling sessions, educational booklets, cartoon visual aids and educational videos, which have the main advantage of promoting patients’ comprehension of BP.…”

Section: Introductionmentioning

confidence: 99%

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

Zhu

Zhang

et al. 2017

J of Digest Diseases

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Colonoscopy remains the mainstay in diagnosing and monitoring colorectal cancer and other colorectal lesions. The diagnostic efficiency of colonoscopy greatly depends on the quality of bowel preparation, which is closely associated with the patient's compliance with the preparation instructions. In addition, the procedural requirements of bowel preparation are often complex and difficult for patients to comprehend and memorize, especially those with lower health literacy and motivation. Therefore, in recent years, many educational methods have been developed, such as educational booklets, cartoon visual aids, educational videos, short message service, telephone, social media and smart phone applications. These educational methods have significantly improved compliance with the instructions for bowel preparation and ultimately promoted the visualization of the colon in patients undergoing colonoscopy.

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Enhanced instructions improve the quality of bowel preparation for colonoscopy: a meta-analysis of randomized controlled trials

Cited by 90 publications

References 27 publications

Optimal Bowel Cleansing for Colonoscopy in the Elderly Patient

Optimal Bowel Cleansing for Colonoscopy in the Elderly Patient

Video education can improve awareness of risks for patients undergoing endoscopic retrograde cholangiopancreatography: A randomized trial

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

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