Educational video improves bowel preparation in patients undergoing colonoscopy: a systematic review and meta-analysis

Background: Unsatisfactory bowel preparation has been reported in 1/3 of colonoscopy cases, with lack of good bowel preparation knowledge being one of the major causes. Although still unclear, educational video is thought to be a good method of improving bowel preparation. Methods: A systematic review of eight randomized controlled trials (RCTs) comparing the educational video to control group among 1,977 patients was conducted. PubMed, Embase, Clinical Trials.gov, Cochrane Library, and reference lists were searched for relevant reported studies from inception until June 2019. Outcomes of interest included adequate bowel preparation, Ottawa scores, polyp detection, withdraw time, pain scores, and the anxiety state of patients. Besides random events meta-analyses, we also performed a sensitivity analysis to examine whether the results of the meta-analysis were robust. Results: Compared with the conventional group, the educational video group had significantly higher incidence of adequate bowel preparation [overall risk ratio (RR) =1.20, 95% CI: 1.14, 1.25, P<0.001], lower total Ottawa scores [overall standard mean difference (SMD) =-0.66, 95% CI: -0.91, -0.42, P<0.001]. However, there was no statistical difference in polyp detection, and withdraw time between the educational video and conventional groups (P>0.05). In addition, there were no sufficient RCTs to compare the pain scores and anxiety state of patients between the two groups through meta-analysis. Conclusions: Our findings have demonstrated that educational video can improve bowel preparation in patients undergoing colonoscopy.