Improving the Quality of Bowel Preparation: Rewarding Patients for Success or Intensive Patient Education?
| Autor: | Marguerite J. Kutyla, Sam O'Connor, Amanda Whaley, Bradley J. Kendall, Gerald Holtmann, Marcus A. Gray, Luke F. Hourigan, Courtney von Hippel |
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| Rok vydání: | 2020 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty media_common.quotation_subject Psychological intervention Colonoscopy Patient Education as Topic Reward Informed consent Intervention (counseling) medicine Odds Ratio Humans Quality (business) media_common medicine.diagnostic_test business.industry Cathartics Gastroenterology General Medicine Middle Aged Treatment Outcome Trained nurse Bowel preparation Physical therapy Patient Compliance Female business Patient education |
| Zdroj: | Digestive diseases (Basel, Switzerland). 39(2) |
| ISSN: | 1421-9875 |
| Popis: | Introduction and Objectives: The quality of the bowel preparation is a critical parameter for the outcome of colonoscopies. It is well established that the bowel preparation modality (e.g., split or larger volume preparation) significantly improves the quality of the bowel preparation. Patient compliance is another important factor impacting on the quality of bowel preparations that receives relatively little research attention. We aimed to explore if intensified education or a lottery ticket as reward for good bowel preparation could improve outcomes. Methods: After informed consent, all patients received a standardized printed information booklet. In a randomized fashion, patients were offered (a) a lottery scratchy ticket with an opportunity to win $25,000 as “reward” for good bowel preparation, (b) an education session delivered over the phone by a trained nurse, or (c) no additional measure. Results: Overall, the quality of the bowel preparation was rated good or very good in 69.1% (95% CI 61.7–75.7%) of patients. Reward intervention did not influence the quality of bowel preparation (OR 0.42, 95% CI 0.09–1.91, p = 0.260); however, bowel preparation quality decreased in patients randomized to receive the additional education (OR 0.28, 95% CI 0.08–0.96, p = 0.042). Neither intervention significantly impacted on polyp detection rates. Conclusions: Contrasting general beliefs, additional interventions (e.g., incentives or phone consultation) did not improve the quality of the bowel preparation. The unexpected result shows that utilizing extra resources must be balanced against real-world outcomes and may not always provide the expected result. |
| Databáze: | OpenAIRE |
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