American College of Gastroenterology Annual Meeting

American College of Gastroenterology Annual Meeting

November 08, 2012
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Instructional video improved colonoscopy preparation

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LAS VEGAS — Patients who viewed a brief instructional video on proper colon preparation before colonoscopy had cleaner colons with less fluid content during their procedure compared with those who received written instructions alone in a study presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.

Researchers randomly assigned 127 patients undergoing outpatient colonoscopy to receive either written bowel preparation instructions alone or to view a brief instructional video in addition to receiving written instructions. Each patient’s preparation was measured according to the Ottawa Bowel Preparation Quality Scale, which includes the sum of a five-point cleansing scale and a three-point fluid quantity scale, with lower numbers indicating superior preparation. Participants also responded to a questionnaire about their satisfaction with their preparation.

“There’s really no cost to adding a video where we specifically go over the instructions in a stepwise fashion,” researcher Sateesh R. Prakash, MD, Southern Gastroenterology Specialists in Locust Grove, Ga., told Healio.com. “Would that impact how clean the prep is and how satisfied the patient is with their procedure? Because if they’re not satisfied, they’re not going to come back, and if we can’t see properly, [the result] is only so good.”

Patients who watched the video had significantly better aggregate preparation scores (3.08 compared with 5.58; P<.001), and also lower fluid content scores (0.87 compared with 1.22; P=.004) and lower cleansing scores in all evaluated areas of the colon (0.71 compared with 1.47 in the right colon; 0.77 vs. 1.45 in the left colon and 0.73 vs. 1.44 in the transverse colon; P<.001 for all).

Investigators said the majority of patients (approximately 85%) rated their satisfaction a 4 or 5 on a five-point scale, with no discernible effect from the video on patient satisfaction. Patients considered their prep experience less satisfying than a prior colonoscopy in 21% of cases, with older patients more likely than younger ones to have been more satisfied with a previous experience.

Advanced age also was significantly associated with less effective cleaning of the left colon, while researchers noted that patients with more education had significantly better prep in the left colon (P<.05 for all comparisons). No association was observed between prep quality and/or satisfaction and factors such as ethnicity, sex, family history of colon cancer or socioeconomic status.

“We found a huge impact on prep quality using the video,” Prakash said. “We didn’t see a relationship between watching the video and patient satisfaction, but we did see an impact. You can use a video that discusses instructions in less than five minutes and actually get a better quality prep, which allows us to detect things that may otherwise be missed. We can always invent [new] preps … but this is a small thing that can be done to make a huge difference for everyone.”

Disclosure: Prakash received a research grant from Braintree Laboratories, Inc. to conduct the study.

For more information:

Prakash SR. P1418: Improving Quality of Colonoscopy Bowel Preparation with an Educational Video. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.