Instant Messaging Program (Wechat) Improve the Quality of Bowel Preparation

Communication Through Instant Messaging Program for the Improvement of Bowel Preparation: a Two Centers Study

Colonoscopy is the gold standard in the diagnosis of colorectal disease. The success of colonoscopy depends on high-quality bowel preparation by patients. Inadequate bowel cleansing reduces the cecal intubation rate, and the polyp detection rate (PDR). It also increases costs, mostly due to repeated procedures. The quality of bowel cleansing has remained suboptimal even though numerous different products and regimens have been tested and compared in no fewer than six meta-analyses. Therefore, a completely different approach to improve bowel cleansing is welcome.

Here the investigators assume that instant messaging program (Wechat) delivery the detail and FAQ (Frequently Asked Questions) of bowel preparation instructions would improve the quality of the bowel preparation. The Wechat program has some advantages, 1. Wechat supports over 400 million users, nearly half of the mobile subscribers population in China; 2. Wechat provided a real time communications including voice messages, pictures and text exchange timely; 3.Compare with telephone, Wechat is economical of both time and money; 4. Compare with bowel preparation instructional software and litera or cartoon educational booklet, Wechat is more interactive and responsive.

Study Overview

• Status: Completed
• Conditions: Bowel Preparation
• Intervention / Treatment: Other: IMP interactive education

• Study Type: Interventional
• Enrollment (Actual): 770
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Guangdong
    • Foshan, Guangdong, China, 528000
      • Department of gastroenterology, Chancheng Central Hospital of Foshan
  • Shaanxi
    • Xi'an, Shaanxi, China, 710032
      • Department of gastroenterology, Shaanxi Second People's Hospital
    • Xi'an, Shaanxi, China, 710032
      • Xijing Hospital of Digestive Diseases

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• age 18-80
• PEG as purgatives;
• using we-chat software by patients or their relatives
• outpatients

Exclusion Criteria:

• history of colorectal surgery
• known severe colonic stricture or obstructing tumor
• known or suspected bowel obstruction or perforation
• pregnant or lactating women
• patients who cannot give informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Screening
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: IMP education; patients in this group are educated about bowel preparation by instant messaging program and meanwhile a booklet was also sent to them.	Other: IMP interactive education; The detail and FAQ (Frequently Asked Questions) of bowel preparation instructions is delivered by Wechat.; Other Names: Wechat education
No Intervention: normal education; patients in this group are educated about bowel preparation on the day of reservation by nurse for about 15 minutes and meanwhile a booklet was also sent to them.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adequate bowel preparation quality at the time of colonoscopy defined by Ottawa score<6	Ottawa score：A)cleanliness of each part of the colon: 0=excellent 1=good 2=fair 3=poor 4=inadequate B)fluid in whole colon: small=0 moderate=1 large=2 The bowel preparation was considered inadequate if (1) inadequate visualization on colonoscopy defined by Ottawa score≥6; (2) the colonoscopy was cancelled because of poor bowel preparation; (3) incompleted colonoscopy because of inadequate bowel preparation (the Ottawa score was rated as 14 when patients with failed colonoscopy because of inadequate bowel preparation).	up to 5 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Polyp detection rate	The proportion of participants with at least one polyp in each group	up to 5 months
Compliance rate to instruction	The proportion of participants compliance to the instructions of diet and bowel preparation in each group	up to 5 months
Willingness undergo a repeated bowel preparation	The number of participants have a willingness to undergo a repeated bowel preparation if needed	up to 5 months

Collaborators and Investigators

• Sponsor: Air Force Military Medical University, China
• Investigators: Principal Investigator: Yanglin Pan, M.D., Air Force Military Medical University, China; Principal Investigator: Limei Wang, M.D., Department of gastroenterology, Shaanxi Second People's Hospital

Publications and helpful links

General Publications

• Kang X, Zhao L, Leung F, Luo H, Wang L, Wu J, Guo X, Wang X, Zhang L, Hui N, Tao Q, Jia H, Liu Z, Chen Z, Liu J, Wu K, Fan D, Pan Y, Guo X. Delivery of Instructions via Mobile Social Media App Increases Quality of Bowel Preparation. Clin Gastroenterol Hepatol. 2016 Mar;14(3):429-435.e3. doi: 10.1016/j.cgh.2015.09.038. Epub 2015 Oct 20.

Study record dates

Study Major Dates

• Study Start: May 1, 2014
• Primary Completion (Actual): December 1, 2014
• Study Completion (Actual): December 1, 2014

Study Registration Dates

• First Submitted: May 14, 2014
• First Submitted That Met QC Criteria: May 15, 2014
• First Posted (Estimate): May 16, 2014

Study Record Updates

• Last Update Posted (Estimate): December 23, 2014
• Last Update Submitted That Met QC Criteria: December 20, 2014
• Last Verified: December 1, 2014

More Information

Terms related to this study

• Keywords: bowel preparation; instant messaging program
• Other Study ID Numbers: 20140508-5 (Other Identifier: Ethics committee of Xijing Hospital)