“Show Don’t Tell” –Colonoscopy Prep Instructions

A recent study, summarized in this link– Gastroenterology and Endoscopy News, indicates that providing an 11 minute video with colonoscopy prep instructions was more effective than written instructions.  Not only were the cleanouts better, but this resulted in better outcomes including higher adenoma detection rate and higher rates of completed colonosocpy.

Here’s an excerpt:

Dr. Bearelly and his colleagues randomized 298 individuals scheduled for screening colonoscopy to receive either the practice’s usual written instructions, or to receive the paper handout plus an instructional video (right). The 11-minute video—burned on a disk —covers the same instructions as the written materials, but in an interactive format that depicts a typical patient asking questions of one of the practice’s doctors.

The quality of bowel preparation between the two groups differed significantly (P=0.0098). Cecal intubation was 96% in the intervention group compared with 89% in the control group, and the adenoma detection rate was 53% and 42% in the two groups, respectively.

Patients in the intervention group had a Boston Bowel Preparation Score (BBPS) of 6.99±1.87, whereas those in the control group had a score of 6.43±2.54, although the difference was not statistically significant. A BBPS of 6, with a minimum of 2 in each segment, was considered adequate.

Take-home message:  Video instructions for colonoscopy are worthwhile.  In pediatrics, variability in cleanout regimens is a limiting factor.

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2 thoughts on ““Show Don’t Tell” –Colonoscopy Prep Instructions

  1. Hi Dr Hochman,
    Hope you are well – I am one of the peds gi fellows at Emory and wanted to tell you about something really cool I came across yesterday – http://squattypotty.com. I think this would have great utility in our pediatric constipation clinics and wanted to share this with you and see what you thought of it,
    Thank you!
    Sana

    • Sana,

      Thanks for your comments. I looked at their website and I agree that this could be helpful. For a long time, pediatric GIs have recommended adapting toilets or using potty trainers. The thought was that making sure that the child’s feet can push off would help. I think squattypotty makes the point that even better positioning can help further.

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