title: Development and Testing of an Automated 4-Day Text Messaging Guidance as an Aid for Improving Colonoscopy Preparation.
abstract: BACKGROUND
  In gastroenterology a sufficient colon cleansing improves adenoma detection rate and prevents the need for preterm repeat colonoscopies due to invalid preparation. It has been shown that patient education is of major importance for improvement of colon cleansing.
  
  
  OBJECTIVE
  Objective of this study was to assess the function of an automated text messaging (short message service, SMS)-supported colonoscopy preparation starting 4 days before colonoscopy appointment.
  
  
  METHODS
  After preevaluation to assess mobile phone usage in the patient population for relevance of this approach, a Web-based, automated SMS text messaging system was developed, following which a single-center feasibility study at a tertiary care center was performed. Patients scheduled for outpatient colonoscopy were invited to participate. Patients enrolled in the study group received automated information about dietary recommendations and bowel cleansing during colonoscopy preparation. Data of outpatient colonoscopies with regular preparation procedure were used for pair matching and served as control. Primary end point was feasibility of SMS text messaging support in colonoscopy preparation assessed as stable and satisfactory function of the system. Secondary end points were quality of bowel preparation according to the Boston Bowel Preparation Scale (BBPS) and patient satisfaction with SMS text messaging-provided information assessed by a questionnaire.
  
  
  RESULTS
  Web-based SMS text messaging-supported colonoscopy preparation was successful and feasible in 19 of 20 patients. Mean (standard error of the mean, SEM) total BBPS score was slightly higher in the SMS group than in the control group (7.3, SEM 0.3 vs 6.4, SEM 0.2) and for each colonic region (left, transverse, and right colon). Patient satisfaction regarding SMS text messaging-based information was high.
  
  
  CONCLUSIONS
  Using SMS for colonoscopy preparation with 4 days' guidance including dietary recommendation is a new approach to improve colonoscopy preparation. Quality of colonoscopy preparation was sufficient and patients were highly satisfied with the system during colonoscopy preparation.
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar, TU München, München, Germany. Benjamin.walter@lrz.tum.de.
authors.forename: Benjamin Michael
authors.identifier: http://orcid.org/0000-0002-7356-024X
authors.initials: BM
authors.lastname: Walter
authors.forename: Peter
authors.identifier: http://orcid.org/0000-0002-3195-8620
authors.initials: P
authors.lastname: Klare
authors.forename: Bruno
authors.identifier: http://orcid.org/0000-0003-4598-4026
authors.initials: B
authors.lastname: Neu
authors.forename: Roland M
authors.identifier: http://orcid.org/0000-0002-6945-7581
authors.initials: RM
authors.lastname: Schmid
authors.forename: Stefan
authors.identifier: http://orcid.org/0000-0001-8181-4572
authors.initials: S
authors.lastname: von Delius
keywords: colonoscopy; colonoscopy preparation; patient education; short message service