Improving Quality of Colonoscopy Bowel Preparation with an Educational Video: Presidential Poster

Abstract

Purpose: To evaluate the impact of a supplementary bowel preparation instructional video on the quality of colonoscopy preparation and patient satisfaction Methods: 127 patients scheduled for an outpatient colonoscopy were prospectively randomized in a single blinded manner to video or non-video group. In addition to written bowel preparation instructions, patients in the video group viewed a brief instructional video prior to starting their preparation. All patients prepped with SUPREP Bowel Prep Kit and had a morning colonoscopy. Quality of colon preparation was measured by the endoscopist using the Ottawa Bowel Preparation Quality Scale, a validated instrument requiring the endoscopist to rate cleansing in three segments (right colon, mid colon, and recto-sigmoid colon) on a scale of 0 - 4, with 0 indicating perfect cleansing, and overall fluid quantity on a scale of 0 - 2, with 0 indicating no fluid in the colon. The individual scores are summed to create a total score, with lower scores indicating better preparation. Patient satisfaction with preparation was evaluated using a questionnaire. Statistical analysis was employed to evaluate the impact of the colonoscopy video. Results: There were significant differences in the quality of colonoscopy preparation between the video and the non-video group. Participants that watched the video had superior preparation scores in the right colon (0.71 vs 1.47, p<0.001), transverse colon (0.73 vs 1.44, p<0.001), left colon (0.77 vs 1.45, p<0.001), fluid content (0.87 vs 1.22, p=0.004), and aggregate score (3.08 vs 5.58, p<0.001). Video had no impact on patient satisfaction, with about 85% of patients in both groups rating their satisfaction as a 4 or 5 (5 point scale with 5 = satisfied). The higher the patient's level of education, the lower the Ottawa score of the left colon with a correlation of -.20 (p<.05). Age was significantly related to left colon preparation with a correlation of .19 (p<.05) such that older individuals had less effective cleaning in this segment. Although older patients were more likely to find their previous colonoscopy experiences to be more satisfying (significant correlation of .44 (p<.05)), only 21% of all patients who had a prior colonoscopy found the previous experience more satisfying. Socioeconomic status, ethnicity, gender, or family history of colon cancer did not reveal any significant correlation to quality of colonoscopy preparation or patient satisfaction. Conclusion: Adequate bowel cleansing remains an important factor for providing a quality study of the colon. The addition of an instructional bowel preparation video significantly improves the quality of colon preparation. Disclosure: Sateesh R. Prakash, M.D.- research grant from Braintree Laboratories, Inc for the submitted research abstract and study. This research was supported by an industry grant from Braintree Laboratories, Inc.