Affiliations 

  • 1 Pharmacy, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia sivakami_5@yahoo.com
  • 2 Pharmacy, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  • 3 Surgical, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  • 4 Centre for Clinical Trial, Institute for Clinical Research, Shah Alam, Selangor Darul Ehsan, Malaysia
BMJ Open Gastroenterol, 2020 05;7(1).
PMID: 32371502 DOI: 10.1136/bmjgast-2020-000376

Abstract

OBJECTIVE: Preprocedural bowel preparation is necessary for optimal colonoscopy visualisation. However, it is challenging to achieve high-quality bowel preparation among patients scheduled for colonoscopy. This study aims to evaluate the impact of an intensive patient educational programme on the quality of bowel preparation.

DESIGN: An accessor-blinded randomised controlled trial was carried out at the outpatient surgical clinic of a tertiary hospital. Patients were randomly assigned to the control group (received standard written and verbal instructions) or the experimental group (received an intensive and structured educational programme). All subjects completed a questionnaire before colonoscopy to assess their compliance, acceptability, and tolerability towards bowel preparation regime. Quality of bowel preparation was determined using the Boston Bowel Preparation Scale (BBPS).

RESULTS: A total of 300 subjects who fulfilled the inclusion criteria were recruited. The experimental group had a significantly higher proportion of good quality bowel preparation than the control group (98.7% vs 52.3%, p<0.001). The median total BBPS score was also significantly higher in the experimental group (8 vs 5, p<0.001). Factors associated with good quality of bowel preparation included educational programme (OR: 22.79, 95% CI: 4.23 to 122.85, p<0.001), compliance to bowel cleansing agent (OR: 24.98, 95% CI 3.12 to 199.71, p<0.001), very difficult acceptability of preparation (OR: 0.11, 95% CI 0.03 to 0.38, p<0.001), tolerability towards bowel preparation (OR: 4.98, 95% CI 1.44 to 17.20, p<0.011) and hypomotility drugs (OR: 3.03, 95% CI 0.12 to 0.91, p<0.05).

CONCLUSION: An intensive patient educational programme can significantly improve the quality of bowel preparation for colonoscopy.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.