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. 2018 Mar;6(2):283-289.
doi: 10.1177/2050640617717157. Epub 2017 Jul 11.

Educational strategies for colonoscopy bowel prep overcome barriers against split-dosing: A randomized controlled trial

Alida Andrealli  1 , Silvia Paggi  1 , Arnaldo Amato  1 , Emanuele Rondonotti  1 , Gianni Imperiali  1 , Nicoletta Lenoci  1 , Giovanna Mandelli  1 , Natalia Terreni  1 , Giancarlo Spinzi  1 , Franco Radaelli  1
Affiliations

Educational strategies for colonoscopy bowel prep overcome barriers against split-dosing: A randomized controlled trial

Alida Andrealli et al. United European Gastroenterol J. 2018 Mar.

Abstract

Background: A split-dose (SD) regimen is crucial for colonoscopy quality. Compliance with SD for early morning colonoscopy is generally poor. The present study evaluated whether pre-colonoscopy counselling, in addition to a dedicated leaflet, might increase SD uptake.

Methods: Consecutive 50-69-year-old patients undergoing screening colonoscopy before 10 a.m. were randomized to either receive written information only on bowel preparation (Written Group, WG) or written and oral instructions (Written and Oral Group, WaOG). The leaflet strongly encouraged SD adoption. The primary endpoint was the number of patients adopting SD in each group. The secondary endpoints were predictors of SD uptake, compliance with preparation schemes and cleansing adequacy.

Results: A total of 286 patients (143 WG, 143 WaOG) were enrolled (mean age 59.6 ± 6.1 years, men 49.3%). SD was adopted by 114 and 125 patients in the WG and WaOG, respectively (79.7% versus 87.4%, p = 0.079). No significant differences were observed for the proportion of patients with full compliance with preparation scheme (97.9% versus 97.2%, p = 0.99) and of procedures with adequate bowel cleansing (95.6% versus 95.1%, p = 0.77). At multivariate analysis, a > 1 h travel time to the endoscopy service was inversely correlated with SD uptake (odds ratio (OR) 0.30, 95% confidence interval (CI) 0.09-0.98).

Conclusions: Our leaflet guaranteed satisfactory uptake of SD and excellent adherence to the preparation scheme for early morning colonoscopy. Its use might marginalize the need for additional oral instructions, particularly in open-access settings.

Keywords: Colonoscopy; bowel preparation; colonoscopy quality; colorectal cancer screening; split dose.

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Figures

Figure 1.
Figure 1.
Flow diagram of patients. WG: Written Group; WaOG: Written and Oral Group.
See this image and copyright information in PMC

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