Award: Presidential Poster Award
Nicole S. Evans, MD, MS1, Shida Haghighat, MD, MPH1, Chethan Ramprasad, MD2, Eric Hsieh, MD1
1LAC+USC Medical Center, Los Angeles, CA; 2New York University, New York, NY
Introduction: Achieving adequate bowel preparation can often be difficult for hospitalized patients. More than half of the colonoscopies performed at our large, urban safety net hospital are rated as suboptimal. Given the limited availability of resources in this setting, achieving adequate bowel preparation is paramount to cost effectiveness. The objective of this study is to determine the impact of patient education in the form of counseling and written instruction on the quality of bowel cleanliness at colonoscopy.
Methods: This was a single-blinded, randomized, prospective study. Forty-six inpatients scheduled for colonoscopy were randomized into two groups: intervention and standard of care (SOC). Patients who speak English or Spanish as their primary language were included in this study. The intervention group received a five-minute educational session as well as a pictorial and verbal brochure in their preferred language regarding the purpose of a colonoscopy and value of adequate bowel preparation. The SOC group did not receive this education session or brochure. Both groups were administered a clear liquid diet and four liters polyethylene glycol. Patient demographics, a brief medical history, and length of hospitalization were documented. Endoscopists blinded to randomization used the Boston Bowel Preparation Scale (BBPS) to grade bowel preparation quality.
Results: There were 46 colonoscopies in total, 25 in the SOC group (75% male, mean age 52.6), and 21 in the intervention group (81% male, mean age 55.7). Of these patients, 56.5% preferred Spanish as their primary language when discussing their healthcare. There were no statistically significant differences between the intervention and control group with respect to demographics, BMI, primary language, history of diabetes, family history of colorectal cancer, inpatient narcotic use, need for repeat colonoscopy, baseline educational level, or length of hospitalization. The mean BBPS score in the intervention group was greater than the mean BBPS score in the SOC group (8.6 vs. 6.8; p< 0.01). Greater than 75% of the intervention group received a perfect score of 9, compared to 0.08% in the standard of care group (p < 0.01).
Discussion: Providing both written and verbal education prior to inpatient colonoscopy is a simple and cost-effective way to optimize colonoscopy preparation. In a healthcare setting where resources are scarce, this five-minute intervention significantly improved bowel preparation quality.
Citation: Nicole S. Evans, MD, MS; Shida Haghighat, MD, MPH; Chethan Ramprasad, MD; Eric Hsieh, MD. P1275 - FIVE MINUTE INTERVENTION FOR IMPROVED INPATIENT BOWEL PREPARATION QUALITY AT A LARGE, URBAN SAFETY NET HOSPITAL. Program No. P1275. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.