Is a Picture Worth a Thousand Good Colonoscopy Preps?

From Digestive Disease Week, New Orleans, Louisiana:

Getting patients to do the proper prep for a colonoscopy remains a problem for gastroenterologists. To try to clear up the confusion, some doctors are doing what they can to create patient education materials that take health literacy into account.

One talk at this year’s Digestive Disease Week described the success of educational colonoscopy prep material aimed at a 5th or 6th grade level.

Dr. Brennan Spiegel of the West Los Angeles Veterans Aaffairs Medical Center and his colleagues developed a booklet using both text and pictures to explain the correct preparation, after conducting interviews with patients and providers to identify common barriers. The brochures include capital letters and Xs through pictures of what not to eat or drink, as well as pictures and descriptions of what “clear” fluids are.

For example, “if you can read newspaper through it, it’s clear (picture and description of apple juice). If not, it is not clear (picture and description of orange juice).

The materials also showed a picture of the same stretch of curvy, country road on a clear, sunny day, and during a snowstorm, to illustrate why proper prep is important:  A clear colon is easier for the doctor to “drive” through.

courtesy of flickr user texxxx2005 (creative commons)

courtesy of flickr user Arul Jegadish (creative commons)

In the study presented at the meeting, the researchers randomized 93 colonoscopy patients to receive the new material and 106 controls to receive standard prep instructions. Prep quality was rated using a tool called the Ottawa score. The average Ottawa scores were significantly higher among patients who received the new booklet, even after controlling for multiple variables.

Clinicians, are you developing any new material to improve the quality of your patients’ colonoscopy preps that takes health literacy into account? What works well in your practices?

— Heidi Splete (on twitter @hsplete)

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2 Comments

Filed under Family Medicine, Gastroenterology, IMNG, Internal Medicine, Uncategorized

2 responses to “Is a Picture Worth a Thousand Good Colonoscopy Preps?

  1. Marian

    Why do they think that the problem lies in patient understanding of instructions? Based on my one first-hand experience of the procedure, the main problem is the undrinkable substance that is supposed to clean the colon. I understood the instructions perfectly, but that didn’t make it any easier to ingest the prescribed drink (I think it was Colyte). Isn’t there a better way to prepare?

  2. Chris D. Noel

    I have been using the clean road versus the snowy road idea for awhile now. But my senario is using a mountain road for the curves and at night because the only light isn the colon is the scope.

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