Reinforcing patient education with text messages sent in the days prior to a colonoscopy can help improve bowel cleanliness and adenoma detection while reducing discomfort, according to research published in Gastrointestinal Endoscopy.
Benjamin Walter, MD, of University Hospital Ulm, in Germany, and colleagues, wrote that patients are often put off by the recommended split-dose preparation, leading to even lower low participation rates in colorectal cancer screening.
“Sufficient bowel prep is the cornerstone for successful colonoscopy in terms of diagnostic accuracy, procedural safety and cost effectiveness,” they wrote. “New media, such as [text messages (SMS)], might help close the gap of long-term patient guidance through all parts of colonoscopy preparation and might encourage more patients to participate in CRC screening.”
Walter and colleagues conducted a prospective, endoscopist-blinded multicenter study to investigate the effects of reinforcing patient education and guidance using text messages.
Investigators provided 495 patients with standard instructions for split-dose preparation during an initial appointment. They randomly assigned patients to either a group that received reinforced education starting four days before their procedure or a control group with no additional instructions.
The primary outcome of the study was percentage of insufficient preparation results defined as a Boston Bowel Preparation Scale (BBPS) of less than 6. Researchers also compared the quality of bowel preparation, polyp and adenoma detection rates and patients’ perceived discomfort of the preparation procedure.
A lower percentage of patients in the text message group had insufficient bowel preparation than in the control group (9% vs. 19%; P = .0013), and they had a higher mean BBPS score (7.4±0.1 vs. 6.5±.01; P < .0001).
Walter and colleagues also found that the text message group had a better adenoma detection rate in the right segment of the colon, and they experienced less discomfort during preparation using a number rating scale than the control group. (5.2 vs. 5.8; P = .0042).
“Our study demonstrated the impact of SMS as an effective, well-accepted, and less resource-demanding tool for improving bowel preparation quality,” the researchers wrote. “This was associated with a higher ADR and [sessile serrated adenomas] detection, especially in the right segment of the colon.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.