Effect of physician-provided education on the quality of bowel preparation

Background and study aims: Inadequate bowel preparation in patients scheduled for colonoscopy is an important problem. In our study, we aimed to investigate the effect of physician-provided bowel preparation education on the quality of bowel preparation and process.

Patients and methods: A total of 150 outpatients who were referred to Kocaeli University Medical Faculty Hospital Gastroenterology Unit for colonoscopy between May 2019 and October 2019 were enrolled in our prospective, endoscopist-blinded study. Patients were divided into two groups. Group 1 (education group) included 73 patients who received 10 minutes of verbal information from a physician in addition to a written information form. Group 2 (control group) included 75 patients who received information from a medical secretary in addition to a written information form. During colonoscopy, the quality of bowel preparation was assessed using the Boston bowel preparation scale (BBPS). A BBPS score = 5 was considered adequate bowel preparation. The mean BBPS score, polyp detection rate, cecal intubation rate and time, and procedure time were also evaluated.

Results: The rate of adequate bowel preparation (BBPS score = 5) was 90.4% and 74.7% in groups 1 and 2, respectively (p = 0.021). The odds ratio for having a BBPS score = 5 in the education group was 3.199 compared with the control group (95% confidence interval = 1.254-8.164; p = 0.015). The cecal intubation rates were 91.8% and 88% in groups 1 and 2, respectively (p > 0.05). The cecal intubation time, procedure time, and adenoma detection rates were similar between the groups. The relationships of age, education level, sex, diabetes mellitus, medicine use, procedure time, and intraabdominal surgery with inadequate bowel preparation were analysed using a logistic regression model. Univariate and multivariate analyses revealed no significant factors associated with inadequate bowel preparation.

Conclusions: Patient education on the bowel preparation process via a physician improved the quality of bowel preparation.

Keywords: bowel preparation, colonoscopy, patient education.