Endoscopy 2019; 51(04): S126
DOI: 10.1055/s-0039-1681542
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 14:30 – 16:00: Preparation Club A
Georg Thieme Verlag KG Stuttgart · New York

E-PATIENT COUNSELING TRIAL (E-PACO): COMPUTER BASED PATIENT EDUCATION IS NON-INFERIOR TO NURSE COUNSELING PRIOR TO COLONOSCOPY, A MULTICENTER RANDOMIZED CONTROLLED TRIAL

G Veldhuijzen
1   Radboudumc, Gastroenterology and Hepatology, Nijmegen, Netherlands
,
M Klemt-Kropp
2   Northwest Clinics, Gastroenterology and Hepatology, Alkmaar, Netherlands
,
JS Terhaar sive Droste
3   Jeroen Bosch Hospital, Gastroenterology and Hepatology, Den Bosch, Netherlands
,
B van Balkom
4   Bernhoven Hospital, Gastroenterology and Hepatology, Uden, Netherlands
,
AAJ van Esch
5   Gastroenterology and Hepatology, Radboudumc, Nijmegen, Netherlands
,
JPH Drenth
5   Gastroenterology and Hepatology, Radboudumc, Nijmegen, Netherlands
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aim:

Optimal patient education prior to colonoscopy improves adherence to instructions for bowel preparation and leads to cleaner colons. We developed a computer based education (CBE) supported by video and 3D animations. We hypothesized that CBE may replace current nurse counseling (NC) in most cases, without losing quality of bowel cleanliness during colonoscopy.

Methods:

A prospective, multicenter, endoscopist blinded, non-inferiority randomized controlled trial was conducted. The primary outcome was the rate of successful bowel cleansing, evaluated using the Boston Bowel Preparation Scale (BBPS). Secondary outcome measures were sickness absence, anxiety, satisfaction and information re-call scores. Data was gathered through questionnaires and endoscopy reports. Four endoscopy units participated, with different levels (rural, urban, tertiary). Inclusion criteria were adult age and referral for complete colonoscopy.

Results:

Out of 1035 eligible patients, we randomized 845 patients. After evaluation, 497 patients were included in our per-protocol analyses, 217 in the NC group and 280 in the CBE group. Baseline characteristics were similarly distributed amongst groups. Response rates of patient questionnaires were 100%, 55.6% and 47.3%. Endoscopists scored BBPS in 95% of the cases. Successful bowel cleansing was achieved in 93.2% of the CBE group, which was non-inferior to the NC group (94%); a difference of -0.8% [95% confidence interval -5.1 – 3.5]. BBPS scores were 7.8 (SD 1.62) and 8.0 (SD 1.69), respectively. Sickness absence was significantly more frequent in the NC group (28.0% vs. 4.83%). In the CBE group, only 21.8% of patients needed additional information, resulting in 4.8% extra outpatient visits. Other secondary outcomes showed no significant difference in both groups.

Conclusion:

As modality for patient education, CBE is non-inferior to NC in terms of bowel cleanliness during colonoscopy, with lower patient sickness leave. CBE therefore is practical and efficient for patient education prior to colonoscopy and is recommended for daily practice.