Smartphone App for Bowel Prep Reduced Inadequate Preps and Improved ADR

Smartphone App for Bowel Prep Reduced Inadequate Preps and Improved ADR

Douglas K. Rex, MD, FASGE, reviewing Walter B, et al. Clin Gastroenterol Hepatol 2020 Mar 30.

A variety of apps to assist in bowel preparation have been made available and tested. In a randomized controlled trial in Germany, 500 patients undergoing colonoscopy with MoviPrep were randomized to utilize an app that pushed out reminders about diet and prep dosing versus standard instructions. Patients in both arms received standard oral and written prep instructions, and only colonoscopies scheduled in the morning hours were included. Colonoscopists were blinded to use of the app. 

The overall Boston Bowel Preparation Scale (BBPS) score was higher with the app (7.6 vs 6.7 in controls), and patients in the app group were less likely than those in the control group (8% vs 17%) to have an inadequate prep (BBPS, <6). The adenoma detection rate was also higher with the app (35% vs 27% in controls). Compliance with split dosing occurred more often with the app (91% vs 82% in controls), and compliance with diet instructions was also higher (94% with the app vs 86% in controls).

This app, developed by Norgine, is only available in German. Since all the patients received standard oral and written instructions, the inadequate prep rate of 17% in the control arm with MoviPrep is of some concern. Nevertheless, the results suggest that all pharmaceutical companies selling bowel preparations should develop free downloadable apps in multiple languages that will guide patients through their assigned diet and preparation.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Douglas K. Rex, MD, FASGE


Walter B, Frank R, Ludwig L, et al. Smartphone application to reinforce education increases high-quality preparation for colorectal cancer screening colonoscopies in a randomized trial. Clin Gastroenterol Hepatol 2020 Mar 30. (Epub ahead of print) (

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