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CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(02): E216-E224
DOI: 10.1055/a-0796-6423
Review
Owner and Copyright © Georg Thieme Verlag KG 2019

Use of smartphone applications to improve quality of bowel preparation for colonoscopy: a systematic review and meta-analysis

Madhav Desai
Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, KS, USA
,
Venkat Nutalapati
Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, KS, USA
,
Ajay Bansal
Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, KS, USA
,
Daniel Buckles
Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, KS, USA
,
John Bonino
Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, KS, USA
,
Mojtaba Olyaee
Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, KS, USA
,
Amit Rastogi
Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, KS, USA
› Author Affiliations
Further Information

Publication History

submitted 20 July 2018

accepted after revision 27 September 2018

Publication Date:
18 January 2019 (online)

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Abstract

Introduction Smartphone-based applications (apps) have been used to improve the quality of bowel preparation (prep) but the success rates have been variable. We have performed a systematic review and meta-analysis to evaluate the impact of smartphone apps on bowel preparation.

Methods Electronic databases (MEDLINE, Embase, CINAHL and Cochrane) were reviewed for eligible studies of smartphone apps versus standard education before colonoscopy. The following outcomes were analyzed: pooled rate of adequacy of bowel prep among both arms and Boston bowel preparation score (BBPS) when reported. Pooled analysis was reported as odds ratio (OR) or mean difference in random effect model with Review Manager 5.3 (P ≤ 0.05 for statistical significance).

Results Six studies were eligible with smartphone app (810 patients) vs. standard education (855 patients, control group) for bowel prep. The smartphone app group had a higher proportion of adequate bowel prep compared to the control group: 87.5 % vs 77.5 % (five studies), pooled OR 2.67; 95 %CI 1.00 – 7.13 with P = 0.05. There was substantial heterogeneity in studies with I 2 = 78 %. When analysis was limited to randomized controlled trials (RCTs), smartphone app users had a numerically higher rate of bowel cleansing: 87.1 % vs 76.9 %; however, pooled OR was not statistically significant (OR 2.66, 95 %CI 0.92 – 7.69, P = 0.07). When studies using BBPS were evaluated (n = 3), smartphone app users had higher mean scores (better bowel prep) with a mean difference of 0.9 (95 %CI 0.5 – 1.3), which was statistically significant (P < 0.01).

Conclusion The smartphone app is a novel educational tool that can assist in achieving adequate and better bowel cleansing before colonoscopy.

Supplement 1 – 6

 

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