Impact of a Smart Phone-Based Educational Video on Bowel Preparation and Colonoscopy Adherence: A Propensity Score Matched Analysis

Background and AimsInadequate bowel preparation and high cancellation rates hinder the effectiveness of colonoscopy screening programs. We aimed to evaluate the impact of a novel, personalized video messaging platform on bowel preparation quality and colonoscopy adherence. MethodsWe conducted a before-after intervention study at a large urban academic medical center, comparing outcomes between a historical control group (April-September 2022) and an intervention group receiving personalized video messages (July-November 2023). Primary outcomes were inadequate bowel preparation and colonoscopy cancellation/rescheduling rates. Propensity score matching and multivariable logistic regression were used to adjust for potential confounders. ResultsAmong 1,647 patients who underwent colonoscopy, inadequate bowel preparation occurred in 12.0% of the intervention group versus 20.0% of the historical control group in the propensity score matched analysis (p=0.041). In the larger cohort of 2,802 scheduled patients, the propensity score matched analysis showed a trend toward a 31% reduction in odds of cancellation or rescheduling associated with the educational video, although this did not reach statistical significance (OR 0.69, 95% CI 0.47-1.01, p=0.056). For the logistical regression model, the video was associated with a 42% reduction in odds of cancellation or rescheduling (adjusted OR 0.58, 95% CI 0.44-0.77, p<0.001). ConclusionsImplementation of a personalized video messaging platform was associated with significant improvements in bowel preparation quality and substantial reductions in colonoscopy cancellations/rescheduling. This easily scalable, low-cost intervention has the potential to enhance the efficiency and effectiveness of colonoscopy screening programs.