Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 22, 2020
Date Accepted: Jun 16, 2021
The effects of a personalized smartphone application on bowel preparation quality: A randomized controlled trial
ABSTRACT
Background:
Adequate bowel preparation is essential for visualization of the colonic mucosa during colonoscopy.
Objective:
Aim of this study was to compare instructions provided via a personalized smartphone application with regular written instructions for bowel preparation in improving bowel preparation quality, and to evaluate patient satisfaction concerning the bowel preparation procedure.
Methods:
Eligible patients scheduled for an outpatient colonoscopy were randomized to the smartphone application or control group. Both groups received identical face-to-face education from a research physician including instructions about the colonoscopy procedure, diet restrictions, and intake of the laxative. In addition, the control group received written information, whereas the smartphone application group was instructed to use the smartphone application instead of the written information. All patients used bisacodyl and sodium picosulfate with magnesium citrate as laxative. Quality of bowel preparation was scored using the Boston Bowel Preparation Scale by blinded endoscopists. Patient satisfaction was measured by the patient satisfaction questionnaire-18 (PSQ-18).
Results:
In total 87 patients participated in the smartphone application group and 86 in the control group. The mean total Boston bowel preparation scale was significantly higher in the smartphone application group (8.3±0.9) compared to the control group (7.9±1.2, P=.03). The right colon showed a significantly higher bowel preparation score in the smartphone application group (2.7±0.5 vs 2.5±0.6, P=.04). General patient satisfaction was high for the smartphone application group (4.4±0.7), but showed no significant difference compared to the control group (4.3±0.8, P=.32).
Conclusions:
Our personalized smartphone application significantly improved bowel preparation quality, in particular in the right colon, but does not further improve patient satisfaction compared to patients receiving regular written instructions. Clinical Trial: ClinicalTrials.gov NCT03677050; https://clinicaltrials.gov/ct2/show/NCT03677050
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