Aims:
Sufficient bowel preparation is crucial for successful screening and surveillance colonoscopy. We investigated the effects of reinforced patient education using a smartphone application for colonoscopy preparation.
Methods:
In this prospective, endoscopist-blinded, multi-center study, standard instructions pertaining to split-dose preparation were provided orally and in a written format to all patients during the initial appointment. Patients were then randomly assigned (1:1) to a group that received reinforced education starting 3 days before the colonoscopy (APP group) or a control group without further education. The primary outcome was quality of bowel preparation according to the Boston Bowel Preparation Scale (BBPS). The secondary outcomes included adenoma detection rates (ADR), patients' perceived discomfort of the preparation procedure and complete implementation of laxative intake and diet assessed by a self-reporting questionnaire.
Results:
So far, 440 patients have been included. Indication for colonoscopy was CRC-screening (n = 212) or surveillance after previous polypectomy (n = 228). Mean BBPS score was significantly higher in the APP group (7.5 ± 0.1) than in the control group (6.3 ± 0.2) (P < 0.0001). The ADR was significantly higher in the APP group (39 vs. 28%) (P = 0.0084) showing that ADR correlates with BBPS. Patients randomized for the APP group reported a lower level of discomfort during preparation 7.5 vs. 7.1 (NRS) (P < 0.0001) and a higher rate of complete ingestion of recommended amount of laxatives 95% vs. 86% (P < 0.001).
Conclusions:
Reinforced patient education using a smartphone application increased bowel cleanliness. Furthermore, using an APP for instruction was associated with an increase in adenoma detection rate and patients' acceptance.
