INFLUENCE OF REINFORCED PATIENT EDUCATION ON THE QUALITY OF BOWEL PREPARATION EVALUATED BY BBPS OR OBPS: SYSTEMATIC REVIEW AND META-ANALYSIS

Jinbao Zhang*, Qiyu Shi*, Junli Fan*, Jianbo Zhang**, #

*Center of Endoscopy, Cangzhou People’s Hospital, Cangzhou, Hebei, 061000, China - **Cardiolovascular Medicine Ward VI, Cangzhou Central Hospital, Cangzhou, Hebei, 061000, China

Background: Colonoscopy has been an important tool for the diagnosis, screening, surveillance and treatment of colorectal lesions, and endoscopy success depends on the skill of the endoscopist as well as colonic preparation. We conducted a systematic review and meta-analysis to summarize the impact of reinforced patient education in various ways on the quality of bowel preparation.

Materials/Methods: We searched PubMed (1977-2016), Embase (1974-2016) and the Cochrane Library (2015) databases to identify relevant articles. We collected information on the effect of reinforced patient education on the quality of bowel preparation evaluated by the Ottawa bowel preparation scale (OBPS), Boston bowel preparation scale (BBPS), detection rate (PDR), adenoma detection rate (ADR) and caecal incubation rate (CIR). Pooled effect WMD (weighted mean difference) was calculated on Stata 11.0 and Review Manager 5.3.

Results: A total of eight trials were eligible in our meta-analysis. It indicated that reinforced education for patients significantly improved the quality of bowel preparation evaluated by OBPS (WMD =  1.19; 95% CI: -1.72, -0.65; P<0.001) and BBPS (WMD = 0.83; 95% CI: 0.41, 1.24; P<0.001). In addition, it resulted in a pooled RR of 0.38 (95% CI: 0.24–0.59; P<0.001), suggesting a higher CIR for experimental groups compared with controls, with no obvious heterogeneity (I2 = 0, P = 0.96). Higher PDR (RR = 0.86; 95% CI: 0.79–0.93; P<0.001) and ADR significantly (RR = 0.93; 95% CI: 0.89–0.98; P = 0.01) were also found in educational groups compared with controls.

Conclusions: Our analysis demonstrates that reinforced education for patients could improve the quality of bowel preparation evaluated by OBPS and BBPS. In addition, it also could increase CIR, PDR and ADR.