Delivery of Instructions via Mobile Social Media App Increases Quality of Bowel Preparation.
OBJECTIVE
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.
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Xiaoyu
X
Kang
Department of Radiotherapy, Xijing Hospital, Fourth Military Medical University, Xian, China.
Lina
L
Zhao
Sepulveda ACC, VA Greater Los Angeles Healthcare System, North Hill, California; David Geffen School of Medicine at UCLA, Los Angeles, California.
Felix
F
Leung
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Hui
H
Luo
Department of Gastroenterology, Shaanxi Second People's Hospital, Xian, China.
Limei
L
Wang
Department of Gastroenterology, Chancheng Central Hospital of Foshan, Foshan, China.
Ji
J
Wu
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Xiaoyang
X
Guo
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Xiangping
X
Wang
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Linhui
L
Zhang
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Na
N
Hui
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Qin
Q
Tao
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Hui
H
Jia
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Zhiguo
Z
Liu
Department of Gastroenterology, Shaanxi Second People's Hospital, Xian, China.
Zhangqin
Z
Chen
Department of Gastroenterology, Chancheng Central Hospital of Foshan, Foshan, China.
Junjun
J
Liu
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Kaichun
K
Wu
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China.
Daiming
D
Fan
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China. Electronic address: yanglinpan@hotmail.com.
Yanglin
Y
Pan
Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China. Electronic address: xuegangguo@gmail.com.
Xuegang
X
Guo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D010045:Outpatients; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D015980:Public Health Practice; D061108:Social Media; D055815:Young Adult
ADR; Bowel Preparation; Colon Cancer Screening