title: Impact of Health Literacy-directed Colonoscopy Bowel Preparation Instruction Sheet.
abstract: OBJECTIVE
  To improve patient colonoscopy bowel preparation with a newly developed simplified instruction sheet in a safety-net hospital system.
  
  
  METHODS
  Bowel preparation quality was compared in a retrospective chart review of 543 patients, 287 of whom received standard instructions (9th grade reading level) between November 2015 and February 2016, and 256 of whom received simplified instructions (6th grade level) between March and May 2016. Instructions were mailed to all patients. The primary outcome was bowel preparation quality recorded by the endoscopist as optimal or suboptimal preparation.
  
  
  RESULTS
  543 medical records were reviewed and results indicated a significant association between the instructions used and preparation quality with patients receiving simplified instructions being significantly more prepared (69.1% vs 65.5%) and having a lower cancellation rate (4.7% vs 10.5%), p = .042.
  
  
  CONCLUSIONS
  A no-cost simplified colonoscopy instruction sheet improved bowel preparation among patients in an academic safety-net health system.
authors.affiliation: Professor, Department of Medicine and Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA.
authors.forename: Terry C
authors.initials: TC
authors.lastname: Davis
authors.affiliation: Research Associate, Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA.
authors.forename: Jill
authors.initials: J
authors.lastname: Hancock
authors.affiliation: Assistant Professor, Department of Medicine, Section of Gastroenterology, Louisiana State University Health Sciences Center, Shreveport, LA.
authors.forename: James
authors.initials: J
authors.lastname: Morris
authors.affiliation: Nurse Manager, Gastroenterology Clinic, University Health, Shreveport, LA.
authors.forename: Perry
authors.initials: P
authors.lastname: Branim
authors.affiliation: Clinical Fellow, Department of Medicine, Section of Gastroenterology, Louisiana State University Health Sciences Center, Shreveport, LA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Seth
authors.affiliation: Professor, Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL.
authors.forename: Alfred
authors.initials: A
authors.lastname: Rademaker
authors.affiliation: Associate Professor, Department of Medicine and Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA;, Email: carnol@lsuhsc.edu.
authors.forename: Connie L
authors.initials: CL
authors.lastname: Arnold
mesh_terms: D000368:Aged; D003113:Colonoscopy; D005260:Female; D057220:Health Literacy; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D013663:Teaching