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How Efficacious Are Patient Education Interventions to Improve Bowel Preparation for Colonoscopy? A Systematic Review

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  • Jacob E Kurlander
  • Arjun R Sondhi
  • Akbar K Waljee
  • Stacy B Menees
  • Cathleen M Connell
  • Philip S Schoenfeld
  • Sameer D Saini

Abstract

Background: Bowel preparation is inadequate in a large proportion of colonoscopies, leading to multiple clinical and economic harms. While most patients receive some form of education before colonoscopy, there is no consensus on the best approach. Aims: This systematic review aimed to evaluate the efficacy of patient education interventions to improve bowel preparation. Methods: We searched the Cochrane Database, CINAHL, EMBASE, Ovid, and Web of Science. Inclusion criteria were: (1) a patient education intervention; (2) a primary aim of improving bowel preparation; (3) a validated bowel preparation scale; (4) a prospective design; (5) a concurrent control group; and, (6) adult participants. Study validity was assessed using a modified Downs and Black scale. Results: 1,080 abstracts were screened. Seven full text studies met inclusion criteria, including 2,660 patients. These studies evaluated multiple delivery platforms, including paper-based interventions (three studies), videos (two studies), re-education telephone calls the day before colonoscopy (one study), and in-person education by physicians (one study). Bowel preparation significantly improved with the intervention in all but one study. All but one study were done in a single center. Validity scores ranged from 13 to 24 (maximum 27). Four of five abstracts and research letters that met inclusion criteria also showed improvements in bowel preparation. Statistical and clinical heterogeneity precluded meta-analysis. Conclusion: Compared to usual care, patient education interventions appear efficacious in improving the quality of bowel preparation. However, because of the small scale of the studies and individualized nature of the interventions, results of these studies may not be generalizable to other settings. Healthcare practices should consider systematically evaluating their current bowel preparation education methods before undertaking new interventions.

Suggested Citation

  • Jacob E Kurlander & Arjun R Sondhi & Akbar K Waljee & Stacy B Menees & Cathleen M Connell & Philip S Schoenfeld & Sameer D Saini, 2016. "How Efficacious Are Patient Education Interventions to Improve Bowel Preparation for Colonoscopy? A Systematic Review," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-14, October.
    • Handle: RePEc:plo:pone00:0164442
    DOI: 10.1371/journal.pone.0164442
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    Cited by:

    1. Maria El Bizri & Mariam El Sheikh & Ga Eun Lee & Maida J Sewitch, 2021. "Mobile health technologies supporting colonoscopy preparation: A systematic review and meta-analysis of randomized controlled trials," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-19, March.
    2. Minju Gwag & Jaeyong Yoo, 2022. "Relationship between Health Literacy and Knowledge, Compliance with Bowel Preparation, and Bowel Cleanliness in Older Patients Undergoing Colonoscopy," IJERPH, MDPI, vol. 19(5), pages 1-14, February.

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