title: Improved Bowel Preparation with Multimedia Education in a Predominantly African-American Population: A Randomized Study.
abstract: Background and Aim. Inadequate bowel preparation is a major impediment in colonoscopy quality outcomes. Aim of this study was to evaluate the role of multimedia education (MME) in improving bowel preparation quality and adenoma detection rate. Methods. This was an IRB-approved prospective randomized study that enrolled 111 adult patients undergoing outpatient screening or surveillance colonoscopy. After receiving standard colonoscopy instructions, the patients were randomized into MME group (n = 48) and control group (n = 46). The MME group received comprehensive multimedia education including an audio-visual program, a visual aid, and a brochure. Demographics, quality of bowel preparation, and colonoscopy findings were recorded. Results. MME group had a significantly better bowel preparation in the entire colon (OR 2.65, 95% CI 1.16-6.09) and on the right side of the colon (OR 2.74, 95% CI 1.12-6.71) as compared to control group (p < 0.05). Large polyps (>1 cm) were found more frequently in the MME group (11/31, 35.5% versus 0/13; p < 0.05). More polyps and adenomas were detected in MME group (57 versus 39 and 31 versus 13, resp.) but the difference failed to reach statistical significance. Conclusion. MME can lead to significant improvement in the quality of bowel preparation and large adenoma detection in a predominantly African-American population.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
authors.forename: Shashank
authors.initials: S
authors.lastname: Garg
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
authors.forename: Mohit
authors.initials: M
authors.lastname: Girotra
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
authors.forename: Lakshya
authors.initials: L
authors.lastname: Chandra
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
authors.forename: Vipin
authors.initials: V
authors.lastname: Verma
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
authors.forename: Sumanjit
authors.initials: S
authors.lastname: Kaur
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
authors.forename: Allawy
authors.initials: A
authors.lastname: Allawy
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Secco
authors.affiliation: Johns Hopkins University-Sinai Program in Internal Medicine, Baltimore, MD 21215, USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Anand
authors.affiliation: Division of Gastroenterology, Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21215, USA.
authors.forename: Sudhir K
authors.initials: SK
authors.lastname: Dutta