The Effect of Video-Based Education on Colonoscopy Preparation

Evaluation of the Effect of Video-Based Education on Bowel Preparation Before Colonoscopy

Colonoscopy is a routine procedure for evaluating gastrointestinal symptoms, detecting colorectal cancer, and removing polyps. Its effectiveness depends on patient compliance with bowel preparation instructions. However, inadequate bowel preparation occurs in 20-25% of colonoscopies, often due to non-adherence, medical conditions, or long waiting times. Poor preparation can reduce examination quality, prevent detection of precancerous lesions, and increase healthcare costs. Video-based education has been shown to be more effective than written or verbal instructions in improving bowel preparation. This study aims to evaluate the effect of video-based education on colonoscopy bowel preparation and contribute evidence to optimize patient compliance.

Colonoscopy is a standard procedure performed for the evaluation of gastrointestinal symptoms, colorectal cancer screening, polyp detection, and polyp removal. Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States , and in Türkiye, 21,718 new cases were reported in 2022. These statistics underscore the importance of colonoscopy as a preventive and diagnostic tool.

When conducted properly, colonoscopy is safe and well-tolerated, allowing visualization of the entire colon and distal terminal ileum. The procedure's optimal effectiveness relies heavily on patient compliance with bowel preparation instructions. Unfortunately, inadequate bowel preparation occurs in approximately 20-25% of colonoscopies, often due to non-adherence, medical conditions affecting bowel cleansing, or prolonged waiting times for the procedure.

While interventions addressing medical conditions or waiting times may not always be feasible, non-compliance with preparation instructions represents a modifiable, patient-related factor. Effective bowel preparation requires adherence to dietary recommendations and the use of prescribed laxatives. The quality of preparation impacts examination adequacy, procedure duration, cancellation rates, and the need for repeat colonoscopies. Inadequate preparation can hinder thorough evaluation, prevent detection of precancerous lesions such as polyps, and increase healthcare costs.

Emerging evidence suggests that video-based educational interventions are more effective than traditional written or verbal instructions, phone calls, social media applications, or messaging services in improving patient compliance and bowel preparation quality.

This study aims to assess the effect of video-based education on bowel preparation before colonoscopy. By evaluating its impact on preparation quality and patient adherence, the study seeks to provide evidence for implementing more effective educational strategies in colonoscopy units, thereby optimizing clinical outcomes and resource utilization.

Inclusion Criteria:

• Voluntary participation in the study.
• Outpatient follow-up.
• No prior history of colonoscopy.
• Participant or a household member (spouse, child, parent, sibling) owns and can use a smartphone application.

Exclusion Criteria:

• History of major abdominal surgery.
• Suspected obstructive lesion in the gastrointestinal tract on cross-sectional imaging.
• Impaired swallowing reflex.
• Mental disorder.
• Communication difficulties (speech, perception, comprehension problems).
• Congestive heart failure or kidney failure.
• Pregnancy or breastfeeding.