Educational Colonoscopy Video Enhances Bowel Preparation Quality and Comprehension in an Inner City Population.
Background: Quality of bowel preparation and patient knowledge remains a major barrier for completing colorectal cancer screening. Few studies have tested unique ways to impact patient understanding centering on interactive computer programs, pictures, and brochures. Two studies explored instruction...
| Published in: | Journal of Clinical Gastroenterology Vol. 52; no. 6; pp. 515 - 519 |
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| Main Authors: | , , , |
| Format: | research randomized controlled trial Journal Article |
| Published: |
Lippincott Williams & Wilkins
Jul2018
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130172272&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130172272 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01920790 4BP jtl: Journal of Clinical Gastroenterology issn: 01920790 maglogo: N pubinfo: dt: Jul2018 vid: 52 iid: 6 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 130172272 130172272 NLM28742732 130172272 10.1097/MCG.0000000000000893 NLM28742732 130172272 ppf: 515 ppct: 4 formats: tig: atl: Educational Colonoscopy Video Enhances Bowel Preparation Quality and Comprehension in an Inner City Population. aug: au: Pillai, Ajish Menon, Radha Oustecky, David Ahmad, Asyia affil: Division of Gastroenterology and Hepatology, Drexel University College of Medicine, Philadelphia, PA sug: subj: Colonoscopy Education Colorectal Neoplasms Pathology Early Detection of Cancer Methods Cathartics Therapeutic Use Urban Health Services Videorecording Attitude to Health Patient Education Methods Therapeutic Irrigation Methods Colonoscopy Methods Pennsylvania Human Cathartics Adverse Effects Readability Communication Single-Blind Studies Prospective Studies Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Questionnaires ab: Background: Quality of bowel preparation and patient knowledge remains a major barrier for completing colorectal cancer screening. Few studies have tested unique ways to impact patient understanding centering on interactive computer programs, pictures, and brochures. Two studies explored instructional videos but focused on patient compliance and anxiety as endpoints. Furthermore, excessive video length and content may limit their impact on a broad patient population. No study so far has studied a video's impact on preparation quality and patient understanding of the colonoscopy procedure.Methods: We conducted a single blinded prospective study of inner city patients presenting for a first time screening colonoscopy. During their initial visit patients were randomized to watch an instructional colonoscopy video or a video discussing gastroesophageal reflux disease (GERD). All patients watched a 6 minutes long video with the same spokesperson, completed a demographic questionnaire (Supplemental Digital Content 1, http://links.lww.com/JCG/A352) and were enrolled only if screened within 30 days of their visit. On the day of the colonoscopy, patients completed a 14 question quiz of their knowledge. Blinded endoscopist graded patient preparations based on the Ottawa scale. All authors had access to the study data and reviewed and approved the final manuscript.Results: Among the 104 subjects enrolled in the study, 56 were in the colonoscopy video group, 48 were in GERD video group, and 12 were excluded. Overall, 48% were male and 52% female; 90% of patients had less than a high school education, 76% were African American, and 67% used a 4 L split-dose preparation. There were no differences between either video group with regard to any of the above categories. Comparisons between the 2 groups revealed that the colonoscopy video group had significantly better Ottawa bowel preparation score (4.77 vs. 6.85; P=0.01) than the GERD video group. The colonoscopy video group also had less-inadequate repeat bowel preparations versus the GERD video group (9% vs. 23%; P<0.01). The overall score on the knowledge questionnaire (Supplemental Digital Content 1, http://links.lww.com/JCG/A352) was significantly higher in the colonoscopy video group as compared with the GERD video group (12.77 vs. 11.08; P<0.001. In all patients the overall quiz score positively correlated with preparation quality (odds ratio, 2.31; confidence interval, 1.35-3.94; P<0.001).Conclusions: Our unique population represented an overwhelmingly under-educated (85% had a high school education or less) and minority group (76% African American). They are one of the most at risk of having multiple barriers such as comprehension and reading difficulties resulting in poor preparation examinations and no shows to procedures. Our instructional video proved to be high yield in this population. The patients assigned to watch the colonoscopy video showed a significant increase in "excellent" grade adequate bowel preparation quality by >23% and a significant decrease in "inadequate" bowel preparations by almost 50%. Our study proves that an educational video can improve both comprehension with regard to all aspects of colonoscopy. ClinicalTrials.gov number, NCT02906969. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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