Improving Bowel Preparation for Colonoscopy With a Simple Educational Card

Study Overview
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Brief Summary
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The purpose of this study is to determine whether adding a simple educational card to standard pre-procedure instructions improves the quality of bowel preparation for colonoscopy.

Detailed Description
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Despite written instructions, many patients do not understand the importance of bowel preparation as they prepare for colonoscopy. This often leads to poor compliance with preparation protocol and therefore inadequate bowel preparation. Our goal is to include a simple educational card which will hopefully improve the quality of bowel preparation by providing a visual component with the preparation instructions. This card will stress the importance of drinking the entire bowel preparation and provide representative images of a dirty and clean colon. We will specifically target patients directly booked for screening colonoscopy (those without a pre-procedure office visit). In a randomized fashion, patients in the control group will receive the standard bowel preparation instructions and patients in the intervention group will receive the educational card along with the standard bowel preparation instructions. The primary outcome will be the endoscopist's assessment of the quality of preparation using a standardized bowel preparation scale. Secondary outcomes will include the number and types of polyps found, colonoscope insertion and withdrawal time, and patient satisfaction with the procedure.

Official Title
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Improving Bowel Preparation for Colonoscopy With a Simple Educational Card

Conditions
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Colonic Polyps, Colonic Neoplasms

Intervention / Treatment
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* Other: Educational card


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Outpatients 18 years old or older Referred and scheduled for an elective screening colonoscopy Exclusion Criteria: Inpatients Prisoners Cognitively impaired patients Legally blind patients Patients allergic to polyethylene glycol electrolyte lavage solution

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A<br>Patients in this arm will be given an educational card in addition to the standard pre-endoscopy instructions. | Other: Educational card<br>* A 4x6 inch educational card containing a photo of an unprepared colon and a clean colon with the caption: Drinking all the bowel cleaning medicine as described in the enclosed instructions lets the doctor see your colon better during your colonoscopy.<br>|
| No Intervention: B<br>Patients in this arm will be given the standard pre-endoscopy instructions. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Boston Bowel Preparation Scale Score | An ordinal scale. 0=fully unprepared colon and 9=perfectly clean colon. Higher values represent a better outcome. For reference please see: Lai EJ, Calderwood AH, Doros G, Fix OK, Jacobson BC. The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research. Gastrointestinal Endoscopy 2009;69:620-625. PMCID: PMC2763922 | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to Advance Colonoscope From Anus to Tip of Cecum. | time in minutes to advance colonoscope from anus to tip of cecum during insertion phase of colonoscopy. | 2 years | 
| Time to Withdraw Colonoscope From Tip of Cecum to Anus. | Time in minutes to withdraw colonoscope from tip of cecum to anus during withdrawal phase of colonoscopy | 2 years | 
| Number of Repeat Procedures Recommended Due to Inadequate Bowel Preparation. | The number of times a colonoscopist recommended that the bowel was too unclean to qualify as an acceptable colonoscopy and therefore recommended repeating the procedure after better cleansing. This is both the number of participants with an inadequate preparation and the number of inadequate procedures. These are synonymous. | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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colonoscopy, bowel preparation, patient education, polyp detection