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. 2016 Jun 21;4(2):e75.
doi: 10.2196/mhealth.5289.

Development and Testing of an Automated 4-Day Text Messaging Guidance as an Aid for Improving Colonoscopy Preparation

Benjamin Michael Walter  1 , Peter Klare, Bruno Neu, Roland M Schmid, Stefan von Delius
Affiliations

Development and Testing of an Automated 4-Day Text Messaging Guidance as an Aid for Improving Colonoscopy Preparation

Benjamin Michael Walter et al. JMIR Mhealth Uhealth. .

Abstract

Background: In gastroenterology a sufficient colon cleansing improves adenoma detection rate and prevents the need for preterm repeat colonoscopies due to invalid preparation. It has been shown that patient education is of major importance for improvement of colon cleansing.

Objective: Objective of this study was to assess the function of an automated text messaging (short message service, SMS)-supported colonoscopy preparation starting 4 days before colonoscopy appointment.

Methods: After preevaluation to assess mobile phone usage in the patient population for relevance of this approach, a Web-based, automated SMS text messaging system was developed, following which a single-center feasibility study at a tertiary care center was performed. Patients scheduled for outpatient colonoscopy were invited to participate. Patients enrolled in the study group received automated information about dietary recommendations and bowel cleansing during colonoscopy preparation. Data of outpatient colonoscopies with regular preparation procedure were used for pair matching and served as control. Primary end point was feasibility of SMS text messaging support in colonoscopy preparation assessed as stable and satisfactory function of the system. Secondary end points were quality of bowel preparation according to the Boston Bowel Preparation Scale (BBPS) and patient satisfaction with SMS text messaging-provided information assessed by a questionnaire.

Results: Web-based SMS text messaging-supported colonoscopy preparation was successful and feasible in 19 of 20 patients. Mean (standard error of the mean, SEM) total BBPS score was slightly higher in the SMS group than in the control group (7.3, SEM 0.3 vs 6.4, SEM 0.2) and for each colonic region (left, transverse, and right colon). Patient satisfaction regarding SMS text messaging-based information was high.

Conclusions: Using SMS for colonoscopy preparation with 4 days' guidance including dietary recommendation is a new approach to improve colonoscopy preparation. Quality of colonoscopy preparation was sufficient and patients were highly satisfied with the system during colonoscopy preparation.

Keywords: colonoscopy; colonoscopy preparation; patient education; short message service.

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Conflict of interest statement

Conflicts of Interest: Software support for the study was received from SmartPatient GmbH, Munich, Germany. SmartPatient GmbH did not participate in study design, data collection, data analysis, or manuscript preparation.

Figures

Figure 1
Figure 1
Graphical workflow of the text messaging (short message service, SMS)-guided colonoscopy preparation; examples of SMS text messages.
Figure 2
Figure 2
Average Boston Bowel Preparation Scale (BBPS) score in the short message service (SMS) study group was significantly higher in comparison with the control group (7.3 vs 6.4, P=.035). BBPS: 0, minimum to 9, maximum.
Figure 3
Figure 3
The average Boston Bowel Preparation Scale (BBPS) score (0, minimum to 3, maximum) split for each colon region. SMS: short message service; n.s.: not significant.
See this image and copyright information in PMC

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