EDUCATIONAL TELEPHONE INTERVENTION BY ENDOSCOPY NURSE. IMPACT ON THE ADHERENCE OF OUTPATIENT COLONOSCOPY

Aims:

The growing complexity of colonoscopy in endoscopy units has increased the need for good patient preparation and the endoscopy nurse role is crucial for it. This study was directed to determine the impact of an educational telephone intervention on colonoscopy adherence. The compliance with colonoscopy preparation protocols and patient satisfaction were also assessed.

Methods:

Prospective, randomized, controlled study. All consecutive patients referred for colonoscopy from the primary care centers from February to July 2018 were included. Two groups were designed, one of which received a standardized educational telephone call before the procedure. All patients received medical information from the primary care center and an administrative reminder from the hospital. An intention-to-treat (ITT) and per-protocol (PP) analysis were performed.

Results:

767 patients in each group were initialy enroled. Finally, 747 were included in the control group (CG) and 738 in the interventional group (IG). Telephone contact was achieved in 613 (83%). Non-adherence for colonoscopy was lower in the IG: ITT [8.4%, OR 1.8 (95% CI 1.30 – 2.53), p = 0.0001], PP [4.4%, OR 3.6 (95% CI 2.35 – 5.61), p = 0.0001] compared with the CG [14.3%]. Rescheduling due to non-compliance protocols was higher in the CG [2.3%] compared to the IG: ITT [0.4%, p = 0.003], PP [0.3%, p = 0.003]. Compliance with the cleansing protocols was poor in the CG [correct diet 95.3%, split-dose 89.8%] in comparison with the IG: ITT [correct diet 97.9%, p = 0.01; split-dose 91.8%, p = 0.002], PP [correct diet 98.3%, p = 0.01; split-dose 92.6%, p = 0.002]. The information received was lower rated as excellent or very good in the CG [64.9%] compared with IG: ITT [85%, p = 0.0001], PP [84.9%, p = 0.0001].

Conclusions:

A patient standardized educational telephone intervention performed by an endoscopy nurse improves adherence, protocols compliance and patient satisfaction in outpatient colonoscopy.