Endoscopy Unit, Digest Center, Barcelona, Spain.
Endoscopy Unit, University Hospital Germans Trias i Pujol, Barcelona, Spain.
Dig Endosc. 2015 Jul;27(5):590-5. doi: 10.1111/den.12467. Epub 2015 Mar 20.
Getting ready for a colonoscopy is difficult and involves many steps. Information given to patients is very important for adherence to treatment. We created a novel smart phone application (SPA) aimed to increase bowel preparation quality and patient satisfaction.
We carried out a prospective, endoscopist-blinded, randomized, controlled trial. We enrolled 260 outpatient (58% female, age range 21-75 years) owners of a smartphone. Patients were allocated to two different protocols: instructions provided by SPA (SPA group; n = 108) or written instructions with visual aids (control group; n = 152). All procedures were carried out in the afternoon and patients received the same purgative regimen (2 L polyethylene glycol (PEG) solution plus ascorbic acid), in a full-dose same-day regimen. The study was designed to detect an improvement in quality of bowel preparation using the Harefield Cleansing Scale (HCS) scale. Effect of protocol on patient satisfaction was assessed with a specific questionnaire at the time of colonoscopy.
Proportion of patients who obtained successful bowel preparation for colonoscopy (HCS A or B) was significantly higher in the SPA group than in the control group (100% vs 96.1%, respectively; P = 0.037). Mean global HCS scores were similar in both groups. Patient-reported tolerability and overall experience with the prescribed bowel preparation were significantly higher for the SPA group than for the control group.
Successful cleansing and patient acceptability with the use of SPA were superior to written instructions in outpatients submitted for colonoscopy using 2 L PEG solution plus ascorbic acid.
结肠镜检查前准备较为困难,涉及多个步骤。为提高治疗依从性,向患者提供信息非常重要。我们研发了一款新型智能手机应用程序(SPA),旨在提高肠道准备质量和患者满意度。
我们开展了一项前瞻性、内镜医师盲法、随机、对照试验。共纳入 260 名拥有智能手机的门诊患者(58%为女性,年龄 21-75 岁)。将患者分为两种不同的方案:SPA 提供的指导(SPA 组,n=108)或带视觉辅助的书面指导(对照组,n=152)。所有操作均在下午进行,患者接受相同的泻药方案(2L 聚乙二醇(PEG)溶液加抗坏血酸),采用相同的全剂量一日方案。本研究旨在使用 Harefield 肠道清洁评分(HCS)量表检测肠道准备质量的改善情况。在结肠镜检查时,采用特定问卷评估方案对患者满意度的影响。
SPA 组患者中获得成功结肠镜肠道准备(HCS A 或 B)的比例显著高于对照组(分别为 100%和 96.1%,P=0.037)。两组患者的平均 HCS 总分相似。SPA 组患者对肠道准备的耐受性和整体体验的报告均显著高于对照组。
与书面指导相比,使用 SPA 可提高门诊患者接受 2L PEG 溶液加抗坏血酸进行结肠镜检查时的肠道清洁效果和患者接受度。