Impact of Colonoscopy Preparation Video on Boston Bowel Preparation Score

Abstract

Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States (US) and the third most common cancer in men and the second most common cancer among women. Early detection of localized adenocarcinoma and adenomatous polyps helps to reduce the mortality related to colon cancer. The CSPY preparation (prep) needs to be optimal. This study's purpose was to determine whether a supplemental educational CSPY video in the viewer's native language would improve bowel preparation, among adult patients at the local county medical facility.Figure: CPRIT colonoscopy preparation video.Figure: Final multivariate analysis results.Methods: Patients who underwent a CSPY were assigned according to whether they watched a supplemental educational video on CSPY bowel preparation in their native language. This video reflects the same information provided in written and verbal form at the time of CSPY scheduling. Bowel prep was rated by the endoscopist using the Boston Bowel Prep Score (BBPS). Participant characteristics and BBPS were collected. Results: There were 186 patients; 91 seen in March 2015 (pre-video) and 95 in March 2016 (postvideo). Mean BBPS was 7.9 and 8.54 for the March 2015 and 2016 group, respectively (P value 0.0039). There was statistical difference between the two groups' racial make-up and BBPS. There was no interaction between gender or race and year effect to account for any difference in that factors' performance. Analyzed data supported a consistent gender effect with females having higher success rates, regardless of video intervention (P value-0.003). After controlling for both gender and race, the year is modestly significant (P value-0.025), with the post-video subjects having higher prep success rates. Conclusion: Only females and Hispanics were found to have a statistically significant relationship as a variable to mean BBPS. There was a strong association with the female gender, when BBPS were viewed dichotomously. Upon multivariate analysis, there was a consistent gender effect with females having higher success rates, regardless of video intervention, and a modest video effect, with the post-video subjects having higher prep success rates. A post-hoc power analysis based on our sample size indicated 76% power to detect differences in BBPS, pre- and post-intervention. Limitations include: 1) no assessment of educational level (Illiteracy rate is 40%), 2) single institution setting, and 3) a short recruiting time frame.