scholarly journals Effect of Physician-Delivered Patient Education on the Quality of Bowel Preparation for Screening Colonoscopy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Tze-Yu Shieh ◽  
Ming-Jen Chen ◽  
Chen-Wang Chang ◽  
Chien-Yuan Hung ◽  
Kuang-Chun Hu ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Screening Colonoscopy ◽  
Control Group ◽  
Education Group ◽  
Adenoma Detection ◽  
Secondary Outcomes ◽  
Inadequate Bowel Preparation ◽  
Bowel Preparations ◽  
Intensive Education

Background. Inadequate bowel preparation is common in outpatients undergoing screening colonoscopy because of unawareness and poor adherence to instruction.Methods. Herein, 105 consecutive outpatients referred for screening colonoscopy were enrolled in this prospective, colonoscopist-blinded study. The patients were assigned to an intensive-education group, with 10 minutes of physician-delivered education, or to standard care. At the time of colonoscopy, the quality of bowel preparation was assessed using the Boston Bowel Preparation Scale (BBPS). The primary outcome was a BBPS score ≥5. The secondary outcomes were the mean BBPS score, insertion time, adenoma detection rate, and number of adenomas detected.Results. We analyzed 39 patients who received intensive education and 60 controls. The percentage of adequate bowel preparations with a BBPS score ≥5 was higher in the intensive-education group than in the control group (97.4% versus 80.0%;P=0.01). The adjusted odds ratio for having a BBPS score ≥5 in the intensive-education group was 10.2 (95% confidence interval = 1.23–84.3;P=0.03). Other secondary outcomes were similar in the 2 groups.Conclusions. Physician-delivered education consisting of a brief counseling session in addition to written instructions improves the quality of bowel preparation in outpatients undergoing screening colonoscopy.

scholarly journals A160 THE EFFECT OF AN INSTRUCTIVE VIDEO ON THE BOWEL PREPARATION EXPERIENCE

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 24-25
Author(s):  
D K Saraswat ◽  
P H Fung ◽  
A Dong ◽  
R Sultanian ◽  
O Farooq ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Patient Adherence ◽  
Healthcare Providers ◽  
Screening Colonoscopy ◽  
Control Group ◽  
University Of Alberta ◽  
Research Award ◽  
Bowel Preparations ◽  
Experimental Group

Abstract Background Over 26000 new cases of colorectal cancer (CRC) are diagnosed each year in Canada. This number has been decreased significantly by the implementation of CRC screening that includes removal of any polyps found during colonoscopies. Despite this, approximately 1 in 4 colonoscopies are inadequate for the detection of early neoplasms due to insufficient bowel preparation prior to the colonoscopy. Consequently, there is a need to improve patient adherence to the bowel preparation protocol. Previous research has shown that enhanced education, including the methods and rationale for bowel preparation prior to a colonoscopy, improves the quality of the bowel preparation. Aims We hypothesised that patients with access to a replayable video explaining the bowel preparation protocol and its importance would have increased satisfaction and noninferior bowel preparations. Methods 100 patients undergoing programmatic screening colonoscopy were randomly assigned into one of two groups. The control group was given the standard presentation currently given to patients. The experimental group was given the same presentation and also given access to an educational video. This video is based on Alberta provincial bowel preparations which have been tested and evaluated. Participants in both groups were sent a survey one day after their colonoscopy. Subjects completed a modified version of the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems survey with added questions designed to assess their satisfaction with the education they received on the bowel preparation. Bowel preparation quality was assessed on a 4-point Likert scale by the endoscopist. Results 17 participants (10 female), aged 40–72 (Mage = 60) have enrolled in the study thus far; however, most have yet to have their colonoscopy. Initial results revealed that all participants had high levels of satisfaction with the presentation they were given. Those in the control group indicated that they would have liked to have had access to a video guide to the bowel preparation before their procedure. The participant in the experimental group indicated high levels of satisfaction with this video, noting that it provided important information not available from other sources. Information on the quality of their bowel preparations is pending. Conclusions The use of multimedia explanations of the bowel preparation has promise in improving patient satisfaction with the bowel preparation. Further studies may guide best methods for implementing a video assisted educational model to enhance colonoscopy preparation. Funding Agencies The first author received an Edna Wakefield Rowe Memorial Summer Research Award from the Faculty of Medicine & Dentistry at the University of Alberta to support this work.

scholarly journals Impact of Video Aid on Quality of Bowel Preparation Among Patients Undergoing Outpatient Screening Colonoscopy

2018 ◽  
Vol 11 ◽  
pp. 117955221880330
Author(s):  
Sanna Fatima ◽  
Deepanshu Jain ◽  
Christopher Hibbard
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Adenoma Detection Rate ◽  
Screening Colonoscopy ◽  
Advanced Adenoma ◽  
Control Group ◽  
P Value ◽  
Group I ◽  
Adenoma Detection

Aim: To investigate the effect of video aid on quality of bowel preparation. Study: A retrospective study was done on patients undergoing outpatient screening colonoscopy. All subjects received educational video prior to colonoscopy in addition to the standard counseling. Patient charts were reviewed to collect data regarding quality of bowel preparation (adequate or inadequate). The study population was stratified into four groups according to viewing status: Group I 0% (control group), Group II <50%, Group III >50% to <75%, and Group IV watched ⩾75% of the video. Results: A total of 338 patients with an average age of 59.1 years and 60.3% females were included in the final study cohort. Of the patients in Groups I, II, III, and IV, 94.3%, 90.9%, 100%, and 91.7%, respectively, had adequate preparation ( P value = .827). Adenoma detection rate (ADR) for Groups I, II, III, and IV was 28.8%, 50%, 50%, and 22.6%, respectively ( P value = .305). The mean cecal intubation time was 20.7, 16.4, 16.57, and 17 minutes for Groups I, II, III, and IV, respectively ( P value = .041). Conclusions: Video aid use for patients undergoing screening colonoscopy lacked a statistically significant impact on the quality of bowel preparation, ADR, and advanced adenoma detection rate when compared with standard practice.

scholarly journals Effect of physician-provided education on the quality of bowel preparation

2021 ◽  
Vol 84 (3) ◽  
Author(s):  
B Dikkanoğlu ◽  
A.E. Duman ◽  
S Hülagü
Keyword(s):  
Bowel Preparation ◽  
Control Group ◽  
Procedure Time ◽  
Cecal Intubation ◽  
Detection Rates ◽  
Written Information ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Inadequate Bowel Preparation

Background and study aims : Inadequate bowel preparation inpatients scheduled for colonoscopy is an important problem. Inour study, we aimed to investigate the effect of physician-providedbowel preparation education on the quality of bowel preparationand process. Patients and methods : A total of 150 outpatients who were referredto Kocaeli University Medical Faculty Hospital GastroenterologyUnit for colonoscopy between May 2019 and October 2019 wereenrolled in our prospective, endoscopist-blinded study. Patientswere divided into two groups. Group 1 (education group) included73 patients who received 10 minutes of verbal information froma physician in addition to a written information form. Group 2(control group) included 75 patients who received informationfrom a medical secretary in addition to a written information form.During colonoscopy, the quality of bowel preparation was assessedusing the Boston bowel preparation scale (BBPS). A BBPS score≥ 5 was considered adequate bowel preparation. The mean BBPSscore, polyp detection rate, cecal intubation rate and time, andprocedure time were also evaluated. Results : The rate of adequate bowel preparation (BBPS score≥ 5) was 90.4% and 74.7% in groups 1 and 2, respectively (p =0.021). The odds ratio for having a BBPS score ≥ 5 in the educationgroup was 3.199 compared with the control group (95% confidenceinterval = 1.254-8.164; p = 0.015). The cecal intubation rates were91.8% and 88% in groups 1 and 2, respectively (p > 0.05). The cecalintubation time, procedure time, and adenoma detection rates weresimilar between the groups. The relationships of age, educationlevel, sex, diabetes mellitus, medicine use, procedure time, andintraabdominal surgery with inadequate bowel preparationwere analysed using a logistic regression model. Univariate andmultivariate analyses revealed no significant factors associatedwith inadequate bowel preparation. Conclusions : Patient education on the bowel preparationprocess via a physician improved the quality of bowel preparation.

scholarly journals Surveying ADR knowledge and practices among US gastroenterologists

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Michael Peng ◽  
Douglas Rex, MD, MACG
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Online Survey ◽  
Screening Colonoscopy ◽  
Current Evidence ◽  
Serrated Polyps ◽  
The Past ◽  
Adenoma Detection ◽  
Age And Sex

Background:   The adenoma detection rate (ADR) is of primary importance to the quality of screening colonoscopy. An online survey was conducted to assess knowledge and practices on ADR.  Methods:  Paid questionnaire distributed by email. Eligible respondents were board certified gastroenterologists who perform >80 colonoscopies per month with 3 to 35 years after fellowship.  Results:  39% were unaware that ADR applies only to screening colonoscopies and 76% incorrectly answered that ADR includes sessile serrated polyps/adenomas.  51% of respondents incorrectly believe the threshold is set at 25% because 25% is a national ADR average. Many also believe the threshold depends on the patient population (current evidence suggests adjusting ADR for factors other than age and sex is unnecessary). 75% ranked ADR as highly important. 80% reported tracking ADR. A busy practice was the most common reason for not tracking ADR. Caps, chromoendoscopy, and good bowel preparation were viewed as valuable for improving ADR (this is true except for caps). HD colonoscopes and education were considered less valuable (although evidence suggests HD and education are associated with improved ADR). 57% reported not sharing ADR information with their patients, and 59% reported no patients in the past 6 months asking for their ADR. Conclusion:  The importance of ADR as a validated quality measure is well understood, but there are misconceptions among gastroenterologists regarding the definition and measurement of ADR and which methods are proven to increase ADR.  Patients are having very little impact on ADR measurement.

scholarly journals Improved Bowel Preparation with Multimedia Education in a Predominantly African-American Population: A Randomized Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Shashank Garg ◽  
Mohit Girotra ◽  
Lakshya Chandra ◽  
Vipin Verma ◽  
Sumanjit Kaur ◽  
...  
Keyword(s):  
African American ◽  
Bowel Preparation ◽  
Statistical Significance ◽  
Randomized Study ◽  
Control Group ◽  
American Population ◽  
African American Population ◽  
Multimedia Education ◽  
Adenoma Detection

Background and Aim. Inadequate bowel preparation is a major impediment in colonoscopy quality outcomes. Aim of this study was to evaluate the role of multimedia education (MME) in improving bowel preparation quality and adenoma detection rate. Methods. This was an IRB-approved prospective randomized study that enrolled 111 adult patients undergoing outpatient screening or surveillance colonoscopy. After receiving standard colonoscopy instructions, the patients were randomized into MME group (n=48) and control group (n=46). The MME group received comprehensive multimedia education including an audio-visual program, a visual aid, and a brochure. Demographics, quality of bowel preparation, and colonoscopy findings were recorded. Results. MME group had a significantly better bowel preparation in the entire colon (OR 2.65, 95% CI 1.16–6.09) and on the right side of the colon (OR 2.74, 95% CI 1.12–6.71) as compared to control group (p<0.05). Large polyps (>1 cm) were found more frequently in the MME group (11/31, 35.5% versus 0/13; p<0.05). More polyps and adenomas were detected in MME group (57 versus 39 and 31 versus 13, resp.) but the difference failed to reach statistical significance. Conclusion. MME can lead to significant improvement in the quality of bowel preparation and large adenoma detection in a predominantly African-American population.

scholarly journals Efficacy and Patient Tolerability Profiles of Probiotic Solution with Bisacodyl Versus Conventional Cleansing Solution for Bowel Preparation: A Prospective, Randomized, Controlled Trial

2020 ◽  
Vol 9 (10) ◽  
pp. 3286
Author(s):  
Youn I Choi ◽  
Jong-Joon Lee ◽  
Jun-Won Chung ◽  
Kyoung Oh Kim ◽  
Yoon Jae Kim ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Detection Rate ◽  
Controlled Trial ◽  
Screening Colonoscopy ◽  
Control Group ◽  
Case Group ◽  
Detection Rates ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Bowel Cleansing

Although adequate bowel preparation is essential in screening colonoscopy, patient intolerability to bowel cleansing agents is problematic. Recently, a probiotic mixture solution with bisacodyl emerged to improve patient tolerability. We investigated the efficacy, safety, and patient tolerability profiles of probiotics with bisacodyl versus conventional polyethylene glycol (PEG) solution for bowel preparation for screening colonoscopies in healthy patients in this prospective, randomized, case-control study. In total, 385 volunteers were randomly assigned to receive 2 L of water + 200 mL of probiotic solution (case group, n = 195) or 4 L of PEG solution (control group, n = 190). The efficacy of the bowel cleansing was evaluated using the Ottawa scale system, polyp detection rate, and adenoma detection rate, and the patient tolerability profiles were assessed using a questionnaire. The demographics were not significantly different between groups. When the Ottawa score for each bowel segment was stratified into an adequate vs. inadequate level (Ottawa score ≤ 3 vs. >3), there were no statistical differences between groups in each segment of the colon. There were no significant differences in the polyp and adenoma detection rates between groups (38.42% vs. 32.42, p = 0.30; 25.79% vs. 18.97%, p = 0.11). The case group showed significantly fewer events than the control group, especially nausea, vomiting, and abdominal bloating events. Regarding the overall satisfaction grade, the case group reported significantly more “average” scores (95% vs. 44%, p < 0.001) and were more willing to use the same agents again (90.26% vs. 61.85%, p < 0.001). As patient compliance with bowel preparation agents is associated with an adequate level of bowel cleansing, a probiotic solution with bisacodyl might be a new bowel preparation candidate, especially in patients who show a poor compliance with conventional bowel preparation agents.

Bowel preparation for inpatient colonoscopy: a quality evaluation

2019 ◽  
Vol 17 (4) ◽  
pp. 44-50
Author(s):  
Carolina Clavera Catalan ◽  
Estepa Laura ◽  
Navarrete Almudena ◽  
Milà MªAngels ◽  
Maynard Avonello
Keyword(s):  
Bowel Preparation ◽  
Final Analysis ◽  
University Hospital ◽  
Inclusion Criteria ◽  
Diagnostic Colonoscopy ◽  
Training Plan ◽  
Adenoma Detection ◽  
Bowel Preparations ◽  
Good Preparation

Background: Adequate bowel preparation is a prerequisite for colonoscopy. Good preparation improves adenoma detection and caecal intubation rates, and poor preparation can increase complications, cancellations, rebookings, and overall hospital stay. Methods: A retrospective descriptive study of all inpatient colonoscopies within inclusion criteria at Vall d'Hebron University Hospital from June 2016 to June 2017. This assessed the quality of bowel preparation using the simple, reliable Boston Bowel Preparation Scale (BBPS) and collected data on demographics and the referring unit. Results: Of 10 643 diagnostic and therapeutic colonoscopies performed, 854 (8%) were in inpatient studies, and 126 of these (14.8 %) were excluded. Of 728 patients included in the final analysis, bowel preparation was excellent in 18%, good in 45%, regular in 18% and poor in 19%. Of the 37% with inadequate preparation, 15% had to be repeated. Conclusions: Overall, hospital bowel preparations were insufficient. Proposals for improving the quality of bowel preparation included: recommending a waste-free diet for all new inpatients expected to undergo diagnostic colonoscopy; introducing a more tolerable polyethylene glycol laxative solution; and developing learning materials, such as simple written instructions for inpatients, a training plan for ward nurses and an infographic on the prerequisites for endoscopy.

scholarly journals Risk Factors of Inadequate Bowel Preparation for Screening Colonoscopy

2021 ◽  
Vol 10 (12) ◽  
pp. 2740
Author(s):  
Efrat L. Amitay ◽  
Tobias Niedermaier ◽  
Anton Gies ◽  
Michael Hoffmeister ◽  
Hermann Brenner
Keyword(s):  
Risk Factors ◽  
Bowel Preparation ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Screening Colonoscopy ◽  
Cross Sectional ◽  
Factors Associated ◽  
Screening Practice ◽  
Abdominal Symptoms ◽  
Inadequate Bowel Preparation

The success of a colonoscopy in detecting and removing pre-cancerous and cancerous lesions depends heavily on the quality of bowel preparation. Despite efforts, 20–44% of colonoscopy participants have an inadequate bowel preparation. We aimed to assess and compare risk factors for inadequate bowel preparation and for the presence of advanced colorectal neoplasms in routine screening practice. In this cross-sectional study, among 8125 participants of screening colonoscopy in Germany with a comprehensive assessment of sociodemographic factors, lifestyle and medical history, we examined factors associated with inadequate bowel preparation and with findings of advanced neoplasms using adjusted log-binomial regression models. Among the identified risk factors assessed, three factors were identified that were significantly associated with inadequate bowel preparation: age ≥ 70 years (adjusted prevalence ratios, aPR, 1.50 95%CI 1.31–1.71), smoking (aPR 1.29 95%CI 1.11–1.50) and abdominal symptoms (aPR 1.14 95%CI 1.02–1.27). The same risk factors were also associated with the prevalence of advanced neoplasms in our study (aPR 1.72, 1.62 and 1.44, respectively). The risk factors associated with inadequate bowel preparation in this study were also associated with a higher risk for advanced neoplasms. Inadequate bowel preparation for colonoscopy might lead to missed colorectal cancer (CRC) precursors and the late diagnosis of CRC. People at high risk of advanced neoplasms are in particular need of enhanced bowel preparation.

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