title: Online Educational Video Improves Bowel Preparation and Reduces the Need for Repeat Colonoscopy Within Three Years.
abstract: OBJECTIVE
  Unsatisfactory bowel preparation has been reported in up to 33% of screening colonoscopies. Patients' lack of understanding about how a good bowel preparation can be achieved is one of the major causes. Patient education has been explored as a possible intervention to improve this important endpoint and has yielded mixed results. We compared the proportion of satisfactory bowel preparations and adenoma detection rates between patients who viewed and did not view an educational video on colonoscopy.
  
  
  METHODS
  An educational video on colonoscopy, accessible via the Internet, was issued to all patients with planned procedures between 2010 and 2014. Viewing status of the video was verified through a unique code linked to each patient's medical record. Excellent, good, or adequate bowel preparations were defined as "satisfactory," whereas fair, poor, or inadequate bowel preparations were defined as "unsatisfactory."
  
  
  RESULTS
  A total of 2530 patients undergoing their first outpatient screening colonoscopy were included; 1251 patients viewed the educational video and 1279 patients did not see the video. Multivariate analysis revealed higher rates of satisfactory bowel preparation in the educational video group (92.3% [95% confidence interval [CI], 84.8-96.3] vs 87.4% [95% CI, 76.4-93.7], P <.001). Need for a repeat colonoscopy within 3 years was also higher in patients who did not see the video (6.6% [95% CI, 2.8-14.7] vs 3.3% [95% CI 1.3-7.8], P <.001).
  
  
  CONCLUSIONS
  Patient-centered educational video improves bowel preparation quality and may reduce the need for an earlier repeat procedure in patients undergoing screening colonoscopy.
authors.affiliation: Medicine Institute, Cleveland Clinic, Ohio.
authors.forename: Umar
authors.initials: U
authors.lastname: Hayat
authors.affiliation: Digestive Disease Institute, Cleveland Clinic, Ohio.
authors.forename: Peter J W
authors.initials: PJ
authors.lastname: Lee
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Ohio.
authors.forename: Rocio
authors.initials: R
authors.lastname: Lopez
authors.affiliation: Digestive Disease Institute, Cleveland Clinic, Ohio.
authors.forename: John J
authors.initials: JJ
authors.lastname: Vargo
authors.affiliation: Digestive Disease Institute, Cleveland Clinic, Ohio. Electronic address: rizkm@ccf.org.
authors.forename: Maged K
authors.initials: MK
authors.lastname: Rizk
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D001296:Audiovisual Aids; D002400:Cathartics / Q000627:therapeutic use; D015331:Cohort Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D016208:Databases, Factual; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods*; D014741:Video Recording
chemical_list: D002400:Cathartics
keywords: Bowel preparation rates; Educational video; Outpatient colonoscopy; Screening colonoscopy