Multimedia based education on bowel preparation improves adenoma detection rate: Systematic review & meta‐analysis of randomized controlled trials

Abstract

Background and Aims Colorectal cancer (CRC) is the third most common cause of cancer worldwide. Studies have shown a strong association between screening colonoscopy and a reduced risk of death from colorectal cancers. The incidence of poor bowel preparation has been reported in up to 25% cases. We conducted a systematic review and comprehensive meta‐analysis to evaluate the effect of patient education using multimedia platforms on adenoma detection rate and adequacy of bowel preparation. Methods Multiple databases were searched through May 2020 for studies that reported the efficacy of multimedia education (smartphone app and online audio‐visual aids) in improving quality of bowel preparation and its effect on adenoma detection rate (ADR). Meta‐analysis was performed to determine whether multimedia based patient education (MM) helps improve ADR and bowel preparation quality as compared to controls (CT). Results We included 13 randomized controlled trials with a total of 3754 patients. Eight studies reported outcomes on ADR and 12 reported on adequacy of bowel preparation. Overall ADR was higher in patients receiving multimedia based education as compared to CT (risk ratio (RR) 1.25, confidence interval (CI) 1.01–1.56, P = 0.04). A higher proportion of patients receiving multimedia based education achieved adequate bowel preparation (RR 1.2, CI 1.1–1.3, P = 0.001). In patients with mean age over 50 years, ADR was better in MM cohort as compared to controls (RR 1.3, CI 1.1–1.6, P = 0.001). Conclusion Pre‐colonoscopy patient education using multimedia based platforms seems to improve ADR and the adequacy of bowel preparation.

Supplementary education can improve the rate of adequate bowel preparation in outpatients: A systematic review and meta-analysis based on randomized controlled trials

“…Considering that bowel preparation is not limited to colonoscopy and reinforcement methods are not necessarily named "education", we did not use "colonoscopy" and "education" as search terms to avoid omission. This is also consistent with several related meta-analyses published previously [ 25 , 26 , 41 , 42 ]. Due to the obvious heterogeneity (I 2 = 87%, p <0.00001), we analyzed the source of the heterogeneity.…”

“…Examples included cartoon education booklets [ 12 , 13 ], educational videos [ 14 – 16 ], smartphone applications [ 17 , 18 ], telephone communication [ 7 , 19 – 21 ] and message reminders [ 22 – 24 ]. A recent meta-analysis showed that multimedia education can increase the rate of adequate bowel preparation and the detection rate of adenomas during colonoscopy [ 25 ]. A meta-analysis published in 2017 showed that these methods improved the quality of bowel preparation for colonoscopy [ 26 ].…”

Optimal Timing of Simethicone Supplement for Bowel Preparation: A Prospective Randomized Controlled Trial

“…e quality of colonoscopy is the cornerstone of surveillance colonoscopy program, which is associated with several factors, such as bowel preparation, withdrawal time, endoscopists ' experience, and patients' cooperation [5]. Among these, a high-quality bowel preparation is a critically determinant factor to improve adenoma detection rate (ADR) and reduce the incidence of CRC [6]. Inadequate bowel preparation will lead to prolonged procedure duration, decreased visibility of the colonic mucosa, and low ADR [7].…”

Effect of enhanced patient instructions onHelicobacter pylorieradication: A systematic review and meta‐analysis of randomized controlled trials

“…In recent years, telephone follow‐up, short‐message service, and smartphone applications have been widely used to improve health outcomes in various fields because of the cost‐effectiveness and convenience 29‐31 . Several studies 29,32,33 have shown that pre‐colonoscopy patient education using telephone follow‐up, smartphone applications, short‐message service, and online audio‐visual aids could improve the adequacy of bowel preparation and polyp detection rate. Numerous studies 30,34 have also reported that smartphone apps show unique advantages in the management of chronic diseases such as hypertension and diabetes.…”

“…In recent years, telephone follow-up, short-message service, and smartphone applications have been widely used to improve health outcomes in various fields because of the cost-effectiveness and convenience. [29][30][31] Several studies 29,32,33 have shown that pre-colonoscopy patient education using telephone follow-up,…”