Xiaoyu Kang1, Lina Zhao2, Felix Leung3, Hui Luo1, Limei Wang4, Ji Wu5, Xiaoyang Guo1, Xiangping Wang1, Linhui Zhang1, Na Hui1, Qin Tao1, Hui Jia1, Zhiguo Liu1, Zhangqin Chen4, Junjun Liu5, Kaichun Wu1, Daiming Fan1, Yanglin Pan6, Xuegang Guo7. 1. Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China. 2. Department of Radiotherapy, Xijing Hospital, Fourth Military Medical University, Xian, China. 3. Sepulveda ACC, VA Greater Los Angeles Healthcare System, North Hill, California; David Geffen School of Medicine at UCLA, Los Angeles, California. 4. Department of Gastroenterology, Shaanxi Second People's Hospital, Xian, China. 5. Department of Gastroenterology, Chancheng Central Hospital of Foshan, Foshan, China. 6. Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China. Electronic address: yanglinpan@hotmail.com. 7. Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China. Electronic address: xuegangguo@gmail.com.
Abstract
BACKGROUND & AIMS: Bowel preparation is closely linked to the quality of colonoscopy. We investigated whether delivery of instructions via a social media app increases the quality of colonoscopy by improving adequacy of bowel preparation. METHODS: We performed a prospective study at 3 endoscopic centers in China of 770 colonoscopy outpatients (18-80 years old) with convenient access to Wechat (a widely used mobile social media app) from May through November 2014. Patients were randomly assigned to groups that received standard education along with delivery of interactive information via Wechat (n = 387) or standard education (controls, n = 383). The primary outcome was proportion of patients with adequate bowel preparation (Ottawa score <6). Secondary outcomes included rates of adenoma detection and cecal intubation, cecal intubation time, rates of incomplete compliance with instructions, and patient willingness to repeat bowel preparation. RESULTS:Demographic features were comparable between the groups. A higher proportion of patients in the group that received social media instruction had adequate bowel preparation than the control group (82.2% vs 69.5%, P < .001). Among patients with successful colonoscopies, the group that received social media instruction had lower mean total and segmental Ottawa scores (P < .05). A higher proportion of patients receiving social media instruction also had cecal intubation (97.2% vs 93.2% in controls, P = .014) and were found to have adenomas (18.6% vs 12.0% in controls, P = .012). CONCLUSIONS: Instruction via a mobile social media app, in conjunction with regular instruction, increases subjective measures of adequacy of bowel preparation. Use of the app significantly increased the proportion of patients with successful cecal intubation and in whom adenomas were detected, indicating increased quality of colonoscopy. ClinicalTrials.gov number: NCT02140827.
RCT Entities:
BACKGROUND & AIMS: Bowel preparation is closely linked to the quality of colonoscopy. We investigated whether delivery of instructions via a social media app increases the quality of colonoscopy by improving adequacy of bowel preparation. METHODS: We performed a prospective study at 3 endoscopic centers in China of 770 colonoscopy outpatients (18-80 years old) with convenient access to Wechat (a widely used mobile social media app) from May through November 2014. Patients were randomly assigned to groups that received standard education along with delivery of interactive information via Wechat (n = 387) or standard education (controls, n = 383). The primary outcome was proportion of patients with adequate bowel preparation (Ottawa score <6). Secondary outcomes included rates of adenoma detection and cecal intubation, cecal intubation time, rates of incomplete compliance with instructions, and patientwillingness to repeat bowel preparation. RESULTS: Demographic features were comparable between the groups. A higher proportion of patients in the group that received social media instruction had adequate bowel preparation than the control group (82.2% vs 69.5%, P < .001). Among patients with successful colonoscopies, the group that received social media instruction had lower mean total and segmental Ottawa scores (P < .05). A higher proportion of patients receiving social media instruction also had cecal intubation (97.2% vs 93.2% in controls, P = .014) and were found to have adenomas (18.6% vs 12.0% in controls, P = .012). CONCLUSIONS: Instruction via a mobile social media app, in conjunction with regular instruction, increases subjective measures of adequacy of bowel preparation. Use of the app significantly increased the proportion of patients with successful cecal intubation and in whom adenomas were detected, indicating increased quality of colonoscopy. ClinicalTrials.gov number: NCT02140827.