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Patel SV, Yu D, Taylor C, McKay J, Hookey L. Smartphone Application Versus Standard Instruction for Colonoscopic Preparation: A Randomized Controlled Trial. J Clin Gastroenterol 2024:00004836-990000000-00274. [PMID: 38489496 DOI: 10.1097/mcg.0000000000001988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/01/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE To compare smartphone application (Colonoscopic Preparation) instructions versus paper instructions for bowel preparation for colonoscopy. BACKGROUND Adhering to bowel preparation instructions is important to ensure a high-quality colonoscopy. PATIENTS AND METHODS This randomized controlled trial included individuals undergoing colonoscopy at a tertiary care hospital. Individuals were randomized (1:1) to receive instructions through a smartphone application or traditional paper instructions. The primary outcome was the quality of the bowel preparation as measured by the Boston Bowel Preparation Score. Secondary outcomes included cecal intubation and polyp detection. Patient satisfaction was assessed using a previously developed questionnaire. RESULTS A total of 238 individuals were randomized (n = 119 in each group), with 202 available for the intention-to-treat analysis (N = 97 in the app group and 105 in the paper group). The groups had similar demographics, indications for colonoscopy, and type of bowel preparation. The primary outcome (Boston Bowel Preparation Score) demonstrated no difference between groups (Colonoscopic Preparation app mean: 7.26 vs paper mean: 7.28, P = 0.91). There was no difference in cecal intubation (P = 0.37), at least one polyp detected (P = 0.43), or the mean number of polyps removed (P = 0.11). A higher proportion strongly agreed or agreed that they would use the smartphone app compared with paper instructions (89.4% vs 70.1%, P = 0.001). CONCLUSIONS Smartphone instructions performed similarly to traditional paper instructions for those willing to use the application. Local patient preferences need to be considered before making changes in the method of delivery of medical instructions.
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Affiliation(s)
| | - David Yu
- Department of Surgery, Peterborough Regional Health Centre, Peterborough, Canada
| | - Connie Taylor
- Department of Medicine, Division of Gastroenterology, Queen's University, Kingston
| | - Jackie McKay
- Department of Medicine, Division of Gastroenterology, Queen's University, Kingston
| | - Lawrence Hookey
- Department of Medicine, Division of Gastroenterology, Queen's University, Kingston
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Guan Y, Song Y, Li X, Zhang A, Li R. Impact of WeChat guidance on bowel preparation for colonoscopy: a quasi-experiment study. Sci Rep 2023; 13:11553. [PMID: 37463959 DOI: 10.1038/s41598-023-37435-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 06/21/2023] [Indexed: 07/20/2023] Open
Abstract
Colonoscopy is a standard procedure for screening, monitoring, and treating colorectal lesions. To explore the impact of WeChat guidance on bowel preparation before colonoscopy. This quasi-experiment study included patients who underwent colonoscopy at Qingdao Endoscopy Center between March 2016 and September 2016. The primary outcome was bowel preparation quality (Ottawa score), the secondary outcomes were intubation time, withdrawal time, adenoma detection rate (ADR), and adverse reactions. Finally, 588 patients were included and divided into the WeChat guide (n = 295) and the non-WeChat guide (n = 293) groups, they were comparable in baseline characteristics. The Ottawa score (1.59 ± 1.07 vs. 6.62 ± 3.07, P < 0.001), intubation time (6.47 ± 1.81 vs. 11.61 ± 3.34, P < 0.001), withdrawal time (13.15 ± 3.93 vs. 14.99 ± 6.77, P < 0.001), and occurrence rate of adverse reactions (2.0% vs. 5.5%, P = 0.029) were significantly lower in the WeChat guide group than those in the non-WeChat guide group. ADR was significantly higher in the WeChat guide than that in the non-WeChat guide group (1.47 ± 2.30 vs. 0.84 ± 1.66, P < 0.001). WeChat guidance might improve the quality of bowel preparation and adenoma detection rate, shorten the time of colonoscopy, and reduce adverse reactions in bowel preparation.
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Affiliation(s)
- Yifang Guan
- Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Yanjun Song
- Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Xiaona Li
- Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Aijun Zhang
- Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Ruyuan Li
- Department of Gastroenterology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China.
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Aboye GT, Vande Walle M, Simegn GL, Aerts JM. mHealth in sub-Saharan Africa and Europe: A systematic review comparing the use and availability of mHealth approaches in sub-Saharan Africa and Europe. Digit Health 2023; 9:20552076231180972. [PMID: 37377558 PMCID: PMC10291558 DOI: 10.1177/20552076231180972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Background mHealth can help with healthcare service delivery for various health issues, but there's a significant gap in the availability and use of mHealth systems between sub-Saharan Africa and Europe, despite the ongoing digitalization of the global healthcare system. Objective This work aims to compare and investigate the use and availability of mHealth systems in sub-Saharan Africa and Europe, and identify gaps in current mHealth development and implementation in both regions. Methods The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe. Four databases (Scopus, Web of Science, IEEE Xplore, and PubMed) were used, and articles were evaluated based on predetermined criteria. Details on the mHealth system type, goal, patient type, health concern, and development stage were collected and recorded in a Microsoft Excel worksheet. Results The search query produced 1020 articles for sub-Saharan Africa and 2477 articles for Europe. After screening for eligibility, 86 articles for sub-Saharan Africa and 297 articles for Europe were included. To minimize bias, two reviewers conducted the article screening and data retrieval. Sub-Saharan Africa used SMS and call-based mHealth methods for consultation and diagnosis, mainly for young patients such as children and mothers, and for issues such as HIV, pregnancy, childbirth, and child care. Europe relied more on apps, sensors, and wearables for monitoring, with the elderly as the most common patient group, and the most common health issues being cardiovascular disease and heart failure. Conclusion Wearable technology and external sensors are heavily used in Europe, whereas they are seldom used in sub-Saharan Africa. More efforts should be made to use the mHealth system to improve health outcomes in both regions, incorporating more cutting-edge technologies like wearables internal and external sensors. Undertaking context-based studies, identifying determinants of mHealth systems use, and considering these determinants during mHealth system design could enhance mHealth availability and utilization.
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Affiliation(s)
- Genet Tadese Aboye
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
- School of Biomedical Engineering, Jimma University, Jimma, Ethiopia
| | - Martijn Vande Walle
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
| | | | - Jean-Marie Aerts
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
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Ejtehadi F, Safarpour AR, Nemati R, Aminlari L, Zare E, Sivandzadeh GR, Niknam R. Impact of Multimedia CD Education on the Quality of Colon Preparation; A Single-Blind Randomized Study. Middle East J Dig Dis 2022; 14:431-436. [PMID: 37547506 PMCID: PMC10404098 DOI: 10.34172/mejdd.2022.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 07/19/2022] [Indexed: 08/08/2023] Open
Abstract
Background: Routine bowel preparation instructions are usually given to patients in the form of oral explanations with written instructions. The purpose of this study was to evaluate the effectiveness of multimedia training in the form of video CDs on the quality of colon preparation and other related indicators. Methods: 201 outpatients in three referral academic colonoscopy centers were randomly assigned to two groups. The first group (n=100) received supplementary video CD education besides the routine instructions (VCD group). The second group (n=101) received only routine instruction, which included oral and printed instructions (non-VCD group). Results: Complete use of colon cleansing medication was statistically and significantly better in the VCD group (P=0.038). Duration of colonoscopy was shorter in the VCD group (P=0.001), demand for conscious sedation was lesser in the VCD group (P=0.049), and the quality of colon preparation was better in the VCD group (P<0.00). There was no statistically significant difference in pain sensation (P=0.1), cecal intubation rate (P=0.3), and technical difficulty of the colonoscopy (P=0.1) in both groups. Conclusion: Supplementary education in the form of multimedia CD increases the patients' compliance to cleansing mediation consumption, improves the quality of bowel preparation, and decreases the duration of colonoscopy with lesser demands for conscious sedation.
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Affiliation(s)
- Fardad Ejtehadi
- Gastroenterohepatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Reza Safarpour
- Gastroenterohepatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rasoul Nemati
- Gastroenterohepatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ladan Aminlari
- Gastroenterohepatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Zare
- Gastroenterohepatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Ramin Niknam
- Gastroenterohepatology Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
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Li P, He X, Yang X, Du J, Wu W, Tu J. Patient education by smartphones for bowel preparation before colonoscopy. J Gastroenterol Hepatol 2022; 37:1349-1359. [PMID: 35384043 DOI: 10.1111/jgh.15849] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/15/2022] [Accepted: 03/24/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM We aim to evaluate the effect of smartphone education on the bowel preparation quality of patients undergoing colonoscopy by meta-analysis. METHODS Randomized controlled trials using smartphones to educate patients on bowel preparation for colonoscopy were screened from the PubMed, Web of Science, Cochrane Library, and Embase databases from inception to August 31, 2021. After extracting the data, Review Manager software was used for meta-analysis. RESULTS A total of 12 randomized controlled trials with 4165 patients were included in the meta-analysis. There were 2060 patients in the smartphone group, including 1784 patients with adequate bowel preparation, with a rate of 86.6%, and 2105 patients in the control group, including 1614 patients with adequate bowel preparation, with a rate of 76.7%, and pooled risk ratio (RR) was 1.15 (95% confidence interval [CI]: 1.07-1.23, P < 0.01). Eight included studies reported the adenoma detection rate. The adenoma detection rate in the smartphone group was 26.2%, and the rate in the control group was 19.3%, with an RR of 1.29 (95% CI: 1.03-1.62, P < 0.05). CONCLUSION Using smartphones to educate patients on bowel preparation for colonoscopy improved the quality of bowel preparation and increased the adenoma detection rate.
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Affiliation(s)
- Peng Li
- Cancer Center, Department of Gastroenterology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Xueqian He
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Xufang Yang
- Department of General Medicine, Dinghai Central Hospital (Dinghai District of Zhejiang Provincial People's Hospital), Zhoushan, China
| | - Jing Du
- Cancer Center, Department of Gastroenterology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Weiquan Wu
- Cancer Center, Department of Gastroenterology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Jiangfeng Tu
- Cancer Center, Department of Gastroenterology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
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Abstract
Colorectal cancer (CRC) continues to be the third leading cause of cancer-related deaths in the US. Colonoscopy remains the best preventative tool against the development of CRC. As a result, high-quality colonoscopy is becoming increasingly important. Specifically, recent guidelines have highlighted pre-procedural, peri-procedural, and post-procedural practices, which promise to improve patient outcomes and reduce the mortality and interval cancer rates in patients undergoing colonoscopies. Despite the guidelines and advances in modern endoscopy, the procedure remains provider-dependent, which results in differences in outcomes. As a result, incorporating high-quality colonoscopy approaches early in training is key to improving patient outcomes. Additionally, ensuring that high-quality colonoscopy is practiced widely by endoscopists can lead to the most cost-effective care.
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