Impact of patient education with cartoon visual aids on the quality of bowel preparation for colonoscopy

Jul 31, 2012Gastrointestinal endoscopy

How cartoon visual aids in patient education improve bowel preparation for colonoscopy

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Abstract

Group B exhibited better bowel preparation than group A with a mean Boston Bowel Preparation Scale score of 7.44 ± 1.87 compared to 6.12 ± 2.19.

Patient education using cartoon visual aids is associated with improved bowel preparation quality.
The percentage of patients achieving good bowel preparation (BBPS score ≥5) was higher in the cartoon group (93.1%) compared to the verbal/written instructions group (81.6%).
Older age and the absence of visual aids are linked to poorer bowel preparation outcomes.
Bowel preparation quality was evaluated using multiple scales, indicating consistency in findings across different assessment methods.

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BACKGROUND: High-quality bowel preparation is a prerequisite for colonoscopy. Few studies have evaluated visual aids as a means of improving the quality of bowel preparation.

OBJECTIVE: To assess the effect of patient education by using cartoon visual aids on the quality of bowel preparation.

DESIGN: An endoscopist-blinded, randomized, controlled trial.

SETTING: Tertiary referral center.

SUBJECTS: Patients scheduled for screening colonoscopy in a health examination center.

INTERVENTIONS: Patients were assigned to receive the existing verbal and written instructions (group A) or a new cartoon visual educational instruction (group B) for colonoscopy.

MAIN OUTCOME MEASUREMENTS: The primary endpoint was the quality of bowel preparation, assessed by using the Boston Bowel Preparation Scale (BBPS). Secondary endpoints were the quality of bowel preparation assessed by using the Universal Preparation Assessment Scale; insertion, withdrawal, and workup times; and polyp detection rates in the 2 groups. Logistic regression analysis was performed to determine the factors associated with poor bowel preparation according to a BBPS score less than 5.

RESULTS: Group B exhibited better bowel preparation than group A according to BBPS scores (mean BBPS score, 6.12 ± 2.19 vs 7.44 ± 1.87, P ≤ .01; median BBPS score, 6.00 ± 0.00 vs 9.00 ± 0.00, P ≤ .01; good bowel preparation for colonoscopy, BBPS score ≥5, 81.6% vs 93.1%, P = .02). Multivariate analysis revealed that older age (odds ratio 1.07, P ≤ .01) and no use of visual aids (odds ratio 3.08, P = .02) were independent factors associated with poor bowel preparation.

LIMITATIONS: Single-center study.

CONCLUSIONS: Patient education with cartoons effectively improved bowel preparation for colonoscopy.

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Impact of patient education with cartoon visual aids on the quality of bowel preparation for colonoscopy

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