Abstract
INTRODUCTION: Inadequate bowel preparation was associated with missed advanced neoplasia, lower adenoma detection rates and increased resource utilization for repeat colonoscopies. Text messaging may improve bowel preparation. ANNIE is a new VA text message service allowing for customizable educational and motivational text message reminders about clinical care. Our aim was to study the effectiveness of text messaging (via the ANNIE software) to improve the quality of colonoscopy among veterans. METHODS: We identified veterans scheduled to receive outpatient screening colonoscopies during the time period from 1/1/2019 through 3/31/2019 at the Minneapolis Veterans Affairs Medical Center (n = 640). We enrolled interested veterans to receive a series of text reminders through the ANNIE software platform regarding key steps for their bowel preparation (n = 187), in addition to usual care consisting of a nurse education phone call. Those not interested or not enrolled in ANNIE received usual care only (n = 484). Primary outcome was the total Boston Bowel Preparation (BBPS) score. Secondary outcome was patient satisfaction. RESULTS: The average age of the group was 65; 285 were diabetic, and average BMI was 31. The ANNIE group was more likely to have mental health diagnoses (If this is (Table 1). ANNIE text messaging instructions was associated with a higher BBPS score versus usual care ((8.24 versus 7.89 respectively; P = 0.002) (Figure 1). 100% of patients (n = 34) surveyed after Plan-Do-Study-Act Cycle 2 indicated that they would like to receive texts again for their next colonoscopy. CONCLUSION: ANNIE patients had higher bowel preparations scores compared to control patients, indicating that text message reminders were effective at helping patients follow bowel prep instructions. Data is likely an underestimation of the true impact of intervention as results do not account for patients turned away on day of procedure or aborted procedures. Future study will include measures of clinical significance (i.e. adenoma detection rate).
Published Version
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