Abstract
BackgroundHigh-quality bowel preparation is necessary for colonoscopy. A few studies have been conducted to investigate improvement in bowel preparation quality through patient education. However, the effect of patient education on bowel preparation has not been well studied.MethodsA randomized and prospective study was conducted. All patients received regular instruction for bowel preparation during a pre-colonoscopy visit. Those scheduled for colonoscopy were randomly assigned to view an educational video instruction (video group) on the day before the colonoscopy, or to a non-video (control) group. Qualities of bowel preparation using the Ottawa Bowel Preparation Quality scale (Ottawa score) were compared between the video and non-video groups. In addition, factors associated with poor bowel preparation were investigated.ResultA total of 502 patients were randomized, 250 to the video group and 252 to the non-video group. The video group exhibited better bowel preparation (mean Ottawa total score: 3.03 ± 1.9) than the non-video group (4.21 ± 1.9; P < 0.001) and had good bowel preparation for colonoscopy (total Ottawa score <6: 91.6 % vs. 78.5 %; P < 0.001). Multivariate analysis revealed that males (odds ratio [OR] = 1.95, P = 0.029), diabetes mellitus patients (OR = 2.79, P = 0.021), and non-use of visual aids (OR = 3.09, P < 0.001) were associated with poor bowel preparation. In the comparison of the colonoscopic outcomes between groups, the polyp detection rate was not significantly different between video group and non-video group (48/250, 19.2 % vs. 48/252, 19.0 %; P = 0.963), but insertion time was significantly short in video group (5.5 ± 3.2 min) than non-video group (6.1 ± 3.7 min; P = 0.043).ConclusionThe addition of an educational video could improve the quality of bowel preparation in comparison with standard preparation method.Trial registrationClinical Research Information Service KCT0001836. The date of registration: March, 08th, 2016, Retrospectively registered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-016-0476-6) contains supplementary material, which is available to authorized users.
Highlights
High-quality bowel preparation is necessary for colonoscopy
The addition of an educational video could improve the quality of bowel preparation in comparison with standard preparation method
Many reasons contribute to unsatisfactory bowel cleansing, such as inpatient status, chronic constipation, tricyclic antidepressants, male sex, and later colonoscopy start time, patient compliance could play a major role in poor bowel preparation
Summary
A few studies have been conducted to investigate improvement in bowel preparation quality through patient education. Many reasons contribute to unsatisfactory bowel cleansing, such as inpatient status, chronic constipation, tricyclic antidepressants, male sex, and later colonoscopy start time, patient compliance could play a major role in poor bowel preparation. This may occur by means of an insufficient amount of preparation consumption, improper start time of preparation, incorrect length of preparation time, and use of antidepressants or narcotics [7, 8]. The education of patients before colonoscopy is very important to ensure compliance
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