IMPROVING BOWEL PREPARATION FOR COLONOSCOPY WITH A CARTOON EDUCATIONAL BROCHURE: SINGLE-BLINDED, RANDOMIZED, CONTROLLED TRIAL

Aims The bowel preparation before colonoscopy is still a major concern, and various methods have been development to improve its quality. The aim of this randomized controlled trial was to assess the cartoon educational brochure on improving the quality of bowel preparation.

Methods The patients were randomized assigned into two groups: cartoon educational brochure group and without cartoon educational brochure group. The primary outcomes were quality of the bowel preparation based on Ottawa score and polyp detection rate (PDR) of colorectum. The secondary outcomes included adherence for bowel preparation, patient tolerance of bowel procedure, caecal intubation rate, caecal insertion time, and withdrawal time. We performed logistic regression analysis to investigate the factors predicting the poor bowel preparation and high PDR. This study was registered on Chinese Clinical Trials register (ChiCTR1900024022).

Results We included 660 patients totally, with 330 patients in cartoon educational brochure group (Method A) and 330 patients without cartoon educational brochure (Method B). We analyzed 292 interventions and 294 controls. The median Ottawa scores were 5 in both the in cartoon educational brochure and the control group. 66.7%, 65.5% of patients were regard as qualified bowel preparation (Ottawa score < 6) in patients with or without cartoon educational brochure, respectively (P=0.603). No significant difference was observed in PDR (17.0% vs 20.0%, p=0.316). The secondary outcomes were similar between groups. Constipation and incorrect diet restriction were the independent factors associated with poor bowel preparation. Age and withdraw time were the independent factors associated with high PDR.

Conclusions The cartoon educational brochure did not improve the quality of bowel preparation. Further more effective methods are warranted to develop to improve its quality.