Effect of Visual Booklets to Improve Bowel Preparation in Colonoscopy: Systematic Review with Meta-Analysis

Jul 14, 2023Journal of clinical medicine

Visual Booklets May Improve Bowel Cleaning Before Colonoscopy: Review and Combined Analysis

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Abstract

Adequate bowel preparation was observed in 86.7% of patients using visual booklets compared to 77.5% in the control group.

The odds of achieving adequate bowel preparation were 2.31 times higher for those using booklets.
In studies using a 4-L PEG-based preparation, no significant difference was found in bowel preparation quality between booklets and controls.
Non-PEG formulations showed a better bowel preparation with booklets, with an odds ratio of 5.10.
Outpatients using booklets had a significantly higher odds ratio of 7.13 for adequate preparation compared to controls.
The adenoma detection rate was similar between patients using booklets and those in the control group.

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An optimal bowel preparation for colonoscopy is essential to increasing the quality of the examination. Visual booklets have been proposed with conflicting results to enhance bowel preparation. A literature search was performed in March 2023 in the most important databases. Only RCTs were selected. We calculated odd ratios (OR) for dichotomous outcomes. Mean differences (MD) or standardized mean differences (SMD) were used for continuous outcomes. We estimated heterogeneity with the Chiand the Istatistics. In cases of high heterogeneity, a random effect model was used. Six studies were selected, enrolling 1755 patients overall. Adequate bowel preparation was observed in 86.7% of the booklet group versus 77.5% of the control group, with an OR = 2.31 in favor of the booklet. In studies using a 4-L PEG-based preparation, no difference compared to controls was observed, while in non-PEG formulations, preparation with booklets was better than in controls (OR = 5.10, 95% CI 1.82-14.27,= 0.002). Two studies were performed in an inpatient setting without any differences between booklets and controls, while outpatients receiving booklets had better results (OR = 7.13, 95% CI 5.39-9.45,< 0.001). The adenoma detection rate was similar between the two groups. In conclusion, booklets are useful to improve bowel preparation. Outpatient settings and preparations not containing PEG could benefit more from booklets. 2 2p p

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Effect of Visual Booklets to Improve Bowel Preparation in Colonoscopy: Systematic Review with Meta-Analysis

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