Impact of personalised patient education on bowel preparation for colonoscopy: Prospective randomised controlled trial

Abstract

Background: Adequate bowel preparation is one of the most important quality factors of colonoscopy. Our goal was to analyse the impact of personalised patient education on bowel cleansing preparation for colonoscopy. Methods: We performed a single-blinded, single-centre, prospective randomised trial, where patients were either allocated to a control group, where they received some predefined oral and written information on bowel preparation from the gastroenterologist, or to an intervention group, where patients received additional personalised instructions for bowel preparation and diet from a nurse. The primary outcome was the quality of bowel preparation (Aronchick scale). Results: A total of 229 patients were randomised; 113 to the control group and 116 to the intervention group. In intention-to-treat analysis, bowel preparation was adequate in 62% (95% CI 53–70) of colonoscopies in the intervention group and in 35% (95% CI 26–44) of colonoscopies in the control group (p < 0.001). The absolute risk reduction was 27%, the relative risk was 1.77, and the number needed to treat was 4. Subgroup analysis showed a significant impact of personalised education in patients under 65 years (67 vs. 35%; p < 0.001), in males (60 vs. 33%; p = 0.003), in those with higher educational levels (68 vs. 37%; p = 0.002), in those living in urban areas (68 vs. 40%; p = 0.004), and in those with previous colonoscopy (68 vs. 40%; p = 0.001). Risk factors for inadequate preparation were: male gender (OR = 2.1; 95% CI 1.1–4.1), diabetes mellitus (OR = 3.8; 95% CI 1.2–11.6), chronic constipation (OR = 3.7; 95% CI 1.7–8.2), absence of prior abdominal surgery (OR = 2.2; 95% CI 1.2–4.1), and being in the control group (OR = 2.5; 95% CI 1.4–4.4). Conclusions: Personalised patient education on bowel preparation for colonoscopy significantly improved the quality of bowel preparation.