Abstract
BackgroundIn gastroenterology a sufficient colon cleansing improves adenoma detection rate and prevents the need for preterm repeat colonoscopies due to invalid preparation. It has been shown that patient education is of major importance for improvement of colon cleansing.ObjectiveObjective of this study was to assess the function of an automated text messaging (short message service, SMS)–supported colonoscopy preparation starting 4 days before colonoscopy appointment.MethodsAfter preevaluation to assess mobile phone usage in the patient population for relevance of this approach, a Web-based, automated SMS text messaging system was developed, following which a single-center feasibility study at a tertiary care center was performed. Patients scheduled for outpatient colonoscopy were invited to participate. Patients enrolled in the study group received automated information about dietary recommendations and bowel cleansing during colonoscopy preparation. Data of outpatient colonoscopies with regular preparation procedure were used for pair matching and served as control. Primary end point was feasibility of SMS text messaging support in colonoscopy preparation assessed as stable and satisfactory function of the system. Secondary end points were quality of bowel preparation according to the Boston Bowel Preparation Scale (BBPS) and patient satisfaction with SMS text messaging–provided information assessed by a questionnaire.ResultsWeb-based SMS text messaging–supported colonoscopy preparation was successful and feasible in 19 of 20 patients. Mean (standard error of the mean, SEM) total BBPS score was slightly higher in the SMS group than in the control group (7.3, SEM 0.3 vs 6.4, SEM 0.2) and for each colonic region (left, transverse, and right colon). Patient satisfaction regarding SMS text messaging–based information was high.ConclusionsUsing SMS for colonoscopy preparation with 4 days’ guidance including dietary recommendation is a new approach to improve colonoscopy preparation. Quality of colonoscopy preparation was sufficient and patients were highly satisfied with the system during colonoscopy preparation.
Highlights
MethodsAn optimal bowel preparation for colonoscopy is one of the most important cornerstones for gastroenterologists
In Germany, colon cancer prevention program starts at the age of 50 years, with a full insurance-covered outpatient colonoscopy starting at the age of 55 years
Secondary end points included patient satisfaction and quality of bowel preparation assessed by the Boston Bowel Preparation Scale (BBPS) as rated by the endoscopist
Summary
An optimal bowel preparation for colonoscopy is one of the most important cornerstones for gastroenterologists. In cooperation with the company SmartPatient a fully automated, Web-based SMS text messaging reminder system containing important information on colonoscopy preparation was developed It contains 15 messages (up to 160 characters each) that could be sent to a patient's mobile phone. Date and time of colonoscopy and mobile phone numbers of the SMS study group participants were collected and entered into a fully automated SMS text messaging reminder system (SmartPatient GmbH, Munich, Germany). Secondary end points included patient satisfaction (perception of the message contents as helpful or as a hindrance, whether the reminder system would be chosen for colonoscopy again, and whether the SMS text messaging system could be recommended to friends and relatives) and quality of bowel preparation assessed by the BBPS as rated by the endoscopist. All statistical analyses were performed with statistical software GraphPad Prism (GraphPad Software Inc, La Jolla, CA, USA)
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