Virtual Reality Videos Effective Tool for Colonoscopy Bowel Prep

By Lisa Rapaport

December 15, 2021

(Reuters Health) - Conventional patient education alone may not be as effective for colonoscopy bowel prep as combining traditional materials with virtual reality videos, a randomized trial suggests.

Prior to undergoing colonoscopy with local anesthesia between October 1, 2018, and November 1, 2020, the 346 study participants all received conventional in-person education plus written instructions for bowel prep; half of them also received virtual reality videos that let patients see what the operating room and procedure would look like. None of the patients had a prior colonoscopy, and the primary outcome of the trial was the quality of bowel preparation as measured by the Boston Bowel Preparation Scale (BBPS, scored 0-9 from extremely unsatisfactory to complete preparation) as evaluated by the endoscopist.

Mean BBPS scores were significantly higher in the virtual reality intervention group (7.61) than in the conventional education control group (7.04), researchers report in JAMA Network Open.

"Our finding further confirms that patient education can truly make a difference in colonoscopy," said senior study author Dr. Dong Wu, an associate professor of medicine in the department of gastroenterology at Peking Union Medical College Hospital in Beijing, China.

"What is the most surprising of our study is that patients receiving virtual reality education had not only better bowel preparation, but also more polyps detected," Dr. Wu said by email.

Compared with the conventional education group, patients in the virtual reality group had a higher detection rate for polyps (41.9% vs 26.7%) and for adenomas (32.6% vs 22.1%), the study found. However, the difference between groups in polyp detection rates wasn't statistically significant; this may be due to the study being underpowered for this secondary endpoint.

The virtual reality program developed by the research team was designed to capitalize on immersion, interaction and imagination to encourage patients to pay closer attention to the details of bowel preparation, Dr. Wu said.

An added benefit of the virtual reality videos is that this immersive experience can help reduce anxiety for people who have never experienced a colonoscopy before, Dr. Wu added.

Patients in the virtual reality intervention group had better overall compliance with bowel preparation and also reported higher levels of overall satisfaction with the process than people who received only conventional education.

One limitation of the study is its single-center design. The patients in the study also had higher levels of education and income than the general population in China, which limits generalizability.

Another limitation of the study is that it excluded a basic component of conventional patient outreach deployed in many clinical practices - the telephone. Researchers noted that it's common practice to call patients to remind them of the steps for bowel prep and answer questions by phone to encourage compliance, and it's not clear from the study how virtual reality videos might compare to an approach that includes telephone outreach.

Even so, Dr. Wu sees broad potential for using virtual reality to augment preparation for a wide range of procedures that might cause patient anxiety, such as MRIs, skin biopsies, or joint aspirations.

"We think that to improve the effectiveness of patient education, using virtual videos may be a good idea," Dr. Wu said.

SOURCE: https://bit.ly/3m4W5TD JAMA Network Open, online November 22, 2021.

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