Impact of reinforced education by telephone and short message service on the quality of bowel preparation: a randomized controlled study

Jul 17, 2015Endoscopy

Phone calls and text reminders may improve bowel cleaning quality before procedures

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Abstract

Total BBPS score was significantly higher in the reinforced education groups than in the control group (mean [SD] telephone vs. CONTROL: 7.1 [1.2] vs. 6.3 [1.4], P < 0.001).

Reinforced education through telephone or SMS improved bowel preparation quality compared to control.
No significant differences were found in polyp detection rate or adenoma detection rate among groups.
Patients in reinforced education groups reported lower anxiety and better tolerance during the procedure.
Preparation-to-colonoscopy time of > 6 hours and less than 80% purgative ingestion were linked to inadequate bowel preparation.
Re-education by telephone was associated with a lower incidence of inadequate bowel preparation.

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BACKGROUND AND STUDY AIMS: High quality bowel preparation is essential for successful colonoscopy. This study aimed to assess the impact of reinforced education by telephone or short message service (SMS) on the quality of bowel preparation.

PATIENTS AND METHODS: A prospective, endoscopist-blinded, randomized, controlled study was conducted. Reinforced education groups received additional education via reminders by telephone or SMS 2 days before colonoscopy. The primary outcome was the quality of the bowel preparation according to the Boston Bowel Preparation Scale (BBPS). The secondary outcomes included polyp detection rate (PDR), adenoma detection rate (ADR), tolerance, and subjective feelings of patients.

RESULTS: A total of 390 patients were included. Total BBPS score was significantly higher in the reinforced education groups than in the control group (mean [SD] telephone vs.

CONTROL: 7.1 [1.2] vs. 6.3 [1.4], P < 0.001; SMS vs.

CONTROL: 6.8 [1.3] vs. 6.3 [1.4], P = 0.027). Between the two interventions, there was no significant difference in total BBPS score. PDR and ADR were not different among groups. Reinforced education groups showed lower anxiety and better tolerance compared with controls. A preparation-to-colonoscopy time of > 6 hours and < 80 % of the purgative ingested were independent factors associated with inadequate bowel preparation (BBPS < 5), whereas re-education by telephone was inversely related to inadequate bowel preparation.

CONCLUSION: SMS was the optimal education modality, and was as effective as telephone reminders for the quality of bowel preparation. A reinforced educational approach via telephone or SMS should be individualized, depending on the resource availability of each clinical practice.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT01911052).

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Impact of reinforced education by telephone and short message service on the quality of bowel preparation: a randomized controlled study

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