Education improves colonoscopy appropriateness
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Updated: Jul 10, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Mario Grassini1, Carlo Verna, Edda Battaglia
1Asti, Perugia, Italy.
Background:
Appropriateness in GI endoscopy is critical to face the rising amount of demands. Education of physicians has been advocated to reduce the level of inappropriateness.
Objective:
Our purpose was to assess the effectiveness of an educational program in determining a reduction of inappropriate colonoscopies in an open access system.
Design:
Prospective study.
Setting:
A single endoscopy unit in Italy.
Patients:
A total of 495 consecutive outpatients referred to our endoscopy unit by family physicians for diagnostic colonoscopy before the educational course and 522 after its completion, for a total of 1017 patients.
Main Outcome Measurements:
Inappropriate colonoscopy reduction rates, cost savings, and reduction of waiting lists were evaluated.
Results:
With regard to inappropriate colonoscopies, the post-course group rate of inappropriateness was significantly lower than that of the pre-course group (P < or = .001). The economic savings for 1 year was estimated to be euro19,000. The reduction of the waiting list was about 15% of the original value.
Conclusions:
Education has a high incidence in reducing inappropriate colonoscopies in an open-access system determining reduction of costs and waiting lists.
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