title: Providing Hospitalized Patients With an Educational Booklet Increases the Quality of Colonoscopy Bowel Preparation.
abstract: Inadequate bowel preparation is a problem frequently encountered by gastroenterologists who perform colonoscopies on hospitalized patients. A method is needed to increase the quality of bowel preparation in inpatients. An educational booklet has been shown to increase the overall quality of bowel preparation for outpatients. We performed a prospective study to evaluate the effects of an educational booklet on the quality of bowel preparation in a group of hospitalized patients.
  
  
  
  We performed a randomized, single-blind, controlled trial of all inpatients at a tertiary care medical center scheduled for inpatient colonoscopy from October 2013 through March 2014. They were randomly assigned to groups that were (n = 45) or were not (controls, n = 40) given the booklet before bowel preparation the evening before their colonoscopy. All patients received a standard bowel preparation (clear liquid diet the day before the procedure, followed by split-dose GoLYTELY). At the colonoscopy, the Boston Bowel preparation scale (BBPS) was used to assess bowel preparation. The primary outcome measure was adequate bowel preparation (a total BBPS score ≥6 with all segment scores ≥2). Secondary outcomes assessed included total BBPS score, BBPS segment score, and a total BBPS score of 0.
  
  
  
  There were no differences between the groups in age, race, sex, body mass index, history of colonoscopy, history of polyps, or time of colonoscopy. Twenty-eight patients who received the booklet (62%) and 14 who did not (35%) had an adequate bowel preparation (P = .012). The number needed to treat to attain adequate bowel preparation was 4. After adjusting for age and history of prior colonoscopies, the odds of achieving an adequate bowel preparation and a higher total BBPS score after receipt of the booklet were 3.14 (95% confidence interval, 1.29-7.83) and 2.27 (95% confidence interval, 1.05-4.88), respectively. Three patients in the booklet group and 9 in the no-booklet group had a BBPS score of 0 (P = .036). The mean BBPS segment score was greater for the booklet group than the no-booklet group (right colon, P = .097; transverse colon, P = .023; left colon, P = .045).
  
  
  
  In a randomized controlled trial, we found that providing hospitalized patients with an educational booklet on colonoscopy preparation increases the odds of a quality bowel preparation more than 2-fold.
authors.affiliation: Department of Medicine, Vanderbilt University, Nashville, Tennessee.
authors.forename: William F
authors.initials: WF
authors.lastname: Ergen
authors.affiliation: School of Medicine, Vanderbilt University, Nashville, Tennessee.
authors.forename: Trisha
authors.initials: T
authors.lastname: Pasricha
authors.affiliation: Division of Gastroenterology, Vanderbilt University, Nashville, Tennessee.
authors.forename: Francie J
authors.initials: FJ
authors.lastname: Hubbard
authors.affiliation: Division of Gastroenterology, Vanderbilt University, Nashville, Tennessee.
authors.forename: Tina
authors.initials: T
authors.lastname: Higginbotham
authors.affiliation: Division of Gastroenterology, Vanderbilt University, Nashville, Tennessee.
authors.forename: Tonya
authors.initials: T
authors.lastname: Givens
authors.affiliation: Department of Biostatistics, Vanderbilt University, Nashville, Tennessee.
authors.forename: James C
authors.initials: JC
authors.lastname: Slaughter
authors.affiliation: Division of Gastroenterology, Vanderbilt University, Nashville, Tennessee; Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee. Electronic address: keith.obstein@vanderbilt.edu.
authors.forename: Keith L
authors.initials: KL
authors.lastname: Obstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006266:Health Education / Q000379:methods*; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D011787:Quality of Health Care; D016037:Single-Blind Method; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Educational Material; Endoscopy; Poor Bowel Preparation