Effects of a smartphone mobile application on quality of bowel preparation: A randomized controlled trial.

Objective: Successful colonoscopy depends on adequate bowel preparation, while inadequate preparation increases the risk of missed lesions, procedural difficulties, longer durations, and higher costs. This study evaluated the effectiveness of a smartphone application (KOLONAPP) delivering personalized bowel preparation instructions compared to standard written guidelines in improving preparation quality and patient experience. Methods: A randomized controlled trial was performed at the gastroenterology endoscopy unit of Abdurrahman Yurtaslan Oncology Hospital, Turkey, between June to August 2024. Patients scheduled for outpatient colonoscopy were randomly assigned to either the app group or control group. The control group received standard written preparation instructions, while the app group used KOLONAPP, featuring visuals, a dietary plan, laxative instructions, recommendations, and reminders. Both groups used laxatives containing Senna A + B. The Boston Bowel Preparation Scale (BBPS) was used to assess bowel preparation quality. Results: A total of 104 patients underwent colonoscopy, with 52 in each group. The app group achieved significantly higher mean BBPS scores (7.27 ± 1.52) compared to the control group (6.15 ± 1.37; P <0.05). Adjusted analyses revealed that poor bowel preparation was four times more likely in the control group than the app group (odds ratio 4.274, 95% CI, 1.041-17.440; P = 0.044). The app group also showed better dietary adherence and reported a more positive procedural experience. Conclusions: Personalized smartphone applications like KOLONAPP can significantly improve bowel preparation quality, enhance dietary compliance, and create a better overall patient experience during colonoscopy preparation.*Clinical Trials Registration No. NCT06569277.