Journal Article

Supplementary education can improve the rate of adequate bowel preparation in outpatients: A systematic review and meta-analysis based on randomized controlled trials

Lei, Jiaming, Lü, Muhan, Zhou, Kai, Peng, Shicheng, Xiao, Lijun, Liu, Sixu, Ren, Wensen, Liu, Xiaolan

2022

Overview

Colonoscopy is widely used for the screening, diagnosis and treatment of intestinal diseases. Adequate bowel preparation is a prerequisite for high-quality colonoscopy. However, the rate of adequate bowel preparation in outpatients is low. Several studies on supplementary education methods have been conducted to improve the rate of adequate bowel preparation in outpatients. However, the controversial results presented encourage us to perform this meta-analysis. According to the PRISMA statement (2020), the meta-analysis was registered on PROSPERO. We searched all studies up to August 28, 2021, in the three major electronic databases of PubMed, Web of Science and Cochrane Library. The primary outcome was adequate bowel preparation rate, and the secondary outcomes included bowel preparation quality score, polyp detection rate, adenoma detection rate, cecal intubation time, withdrawal time, nonattendance rate and willingness to repeat rate. If there was obvious heterogeneity, the funnel plot combined with Egger's test, meta-regression analysis, sensitivity analysis and subgroup analysis were used to detect the source of heterogeneity. RevMan 5.3 and Stata 17.0 software were used for statistical analysis. A total of 2061 records were retrieved, and 21 full texts were ultimately included in the analysis. Our meta-analysis shows that supplementary education can increase the rate of adequate bowel preparation for outpatients (79.9% vs 72.9%, RR = 1.14, 95% CI: 1.08-1.20, I2 = 87%, p<0.00001). Supplementary education shortened the withdrawal time (MD: -0.80, 95% CI: -1.54 to -0.05, p = 0.04) of outpatients, increased the Boston Bowel Preparation Scale (MD: 0.40, 95% CI: 0.36 to 0.44, p<0.00001), reduced the Ottawa Bowel Preparation Scale (MD: -1.26, 95% CI: -1.66 to -0.86, p<0.00001) and increased the willingness to repeat (91.9% vs 81.4%, RR:1.14, 95% CI: 1.04 to 1.25, p = 0.004). Supplementary education for outpatients based on the standard of care can significantly improve the quality of bowel preparation.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adenoma / Adenoma - diagnosis / Biology and Life Sciences / Cathartics - therapeutic use / Cecum / Clinical trials / Colon / Colonoscopy / Colonoscopy - methods / Complications and side effects / Education / Educational films / Educational materials / Evaluation / Gastroenterology / Heterogeneity / Hospitals / Humans / Intestine / Intubation / Irrigation (Medicine) / Laxatives / Medical research / Medicine and Health Sciences / Meta-analysis / Methods / Outpatients / Patient education / Patient outcomes / Patients / Physical Sciences / Polyps / Randomized Controlled Trials as Topic / Regression analysis / Research and Analysis Methods / Sensitivity analysis / Smartphones / Statistical analysis / Subgroups / Systematic review / Teaching methods / Tumors