A21 RANDOMIZED PROSPECTIVE STUDY: IMPACT OF THE PATIENT EDUCATION WEBSITE ON THE QUALITY OF OUTPATIENT BOWEL PREPARATION FOR COLONOSCOPY:

Abstract

Background. Low level bowel cleanliness that occurs in 25{%} of patients, hinders polyp detection rates and limits colonoscopy effectiveness. Those with inadequate preparation have incomplete examinations, fewer polyps detected, more repeat colonoscopies and higher resource utilization. Aside from pharmacological and timing of purgative factors to optimize bowel preparation, non-pharmacological factors that influence patient compliance (i.e., patient education) in the preparation phase can significantly improve bowel preparation quality. Aims. To assess if interactive, individualized web based instruction lead to improved colonoscopy preparation through enhanced patient compliance, satisfactin and tolerability of preparation. Methods. A randomized, prospective, single blinded trial initiated at St. Paul's hospital in Vancouver, B.C. Inclusion criteria: age {>} 19, planned outpatient colonoscopy, and willingness/ ability to participate by reading the online English material supplied by sending the subject a specific domain (which contains the educational platform of information for their colonoscopy). Exclusion criteria: None. Consecutive patients enrolled into the study (target of 450 participants). Data Collected: demographics, cancellations, bowel preparation cleanliness scores as per Boston bowel preparation quality (BBPS) and Ottawa bowel preparation score. Primary end points: percentage of patients that achieve an excellent BBPS following web-based instructions versus paper instructions. Assessment of patient satisfaction, preparation tolerability and patient activation score through post colonoscopy follow-up surveys. Results. As of October 2015, 285 subjects have been recruited. 127 are male; mean age 57 years (range 20-81). 142 were assigned to Group A (paper based) and 143 to Group B (web based). A Fisher's exact test showed a significant difference in the proportion of subjects achieving an excellent BBPS score ≥8 (Group A = 57{%} (81/142), Group B = 71{%} (102/143) p = 0.0136). There was no significant difference in patient reported satisfaction (p = 0.1438), helpfulness (p = 0.1426) or clarity of instructions (p = 0.1183). Conclusions. Interim analysis detected a significant difference in patients achieving excellent bowel preparation scores between interactive individualized web based instructions versus written instructions. This study will continue to recruit until a target sample size of 450 to determine if our other primary end points will achieve significance. We plan to complete recruitment by Dec 2015. If preliminary data is supported by final results; the use of this platform will be encouraged to maximize ideal patient preparations for colonoscopy.