The Effectiveness of Personalized Bowel Preparation Using a Smartphone Camera Application: A Randomized Pilot Study

Abstract

Background We aimed to investigate the effectiveness of a smartphone application that analyzes and judges the optimal dosage of polyethylene glycol (PEG) for bowel preparation. Methods Patients were assigned to use the smartphone camera application (app group) or written instructions (non-app group). The smartphone camera application was programmed to analyze the bowel preparation quality and automatically determine the dosage of PEG from an analysis of stool images. In contrast, the non-app group consumed PEG solution according to the manual. Results The primary outcome was the quality of the bowel preparation based on blinded ratings using the Ottawa bowel preparation scale (OBPS). There was no statistically significant difference in the mean OBPS scores between the two groups (P = 0.950). However, the app group consumed a lower dose of PEG than the non-app group (mean dosage (mL): 3713.2 ± 405.8 versus 3979.2 ± 102.06, P = 0.001). The app group (5-point Likert scale; mean score 4.37 ± 0.895) had high acceptance of the application. Conclusions Although the app group consumed a lower PEG dose, the bowel preparation quality was similar in the two groups. Moreover, use of the smartphone camera application enhanced compliance with the bowel preparation.

Mobile health technologies supporting colonoscopy preparation: A systematic review and meta-analysis of randomized controlled trials

“…Half (50%) the studies were conducted in South Korea [ 29 – 31 , 33 , 35 ], 2 in China [ 32 , 38 ], and one each in Lebanon [ 36 ], Spain [ 34 ], and Germany [ 37 ]. Studies took place in university hospitals [ 31 , 35 , 36 , 38 ], health examination clinics [ 30 ], tertiary-care hospitals [ 33 , 37 ], and hospital outpatient colonoscopy clinics [ 29 , 32 , 34 ]. Participants ranged in age from 18 to 80 years, with average age ranging from 44.4 to 57.6 years.…”

“…Characteristics of the mHealth interventions are presented in Table 2 . MHealth interventions included smartphone apps [ 34 , 36 ], SMS text messages [ 33 , 35 , 37 , 38 ], smartphone camera app [ 31 ], smartphone video clips [ 29 , 30 ], and a social media app (WeChat) [ 32 , 38 ]. Operating platforms were Android only, iOS only, or both.…”

“…Only Kang et al provided two-way communication using WeChat that allowed patients to ask and receive answers to their questions about the bowel preparation [ 32 ]. Jung et al provided a smartphone camera app that analyzed stool images to determine adequacy of the bowel preparation [ 31 ]. All mHealth interventions provided laxative and dietary instructions that were heterogeneous in content.…”

Correlation of Cleanliness among Different Bowel Segments during Colonoscopy: A Retrospective Study

“…Even if clinicians use many methods to improve intestinal cleanliness, such as WeChat, SMS, phone reminder, and laxatives, the intestinal cleanliness is improved to some extent [10][11][12][13][14][15]. Because intestinal cleanliness is the foundation of ADR, even the best new foundation must be achieved with good intestinal cleanliness [16,17].…”

How Can We Achieve Good Compliance for Bowel Preparation?

“…To maintain an appropriate preparation-to-colonoscopy interval, the patient can be informed of the time of the last intake of the preparation agent via short message service [10], according to the scheduled time of colonoscopy. Further, a method of evaluating bowel cleansing using a smartphone application has been introduced to reduce the dosage of the bowel preparation agent [11]. In this issue of Clinical Endoscopy , Jeon et al [12] reported the usage of smartphone mobile messenger to help bowel preparation before colonoscopy.…”