Endoscopy 2019; 51(04): S54-S55
DOI: 10.1055/s-0039-1681331
ESGE Days 2019 oral presentations
Friday, April 5, 2019 14:30 – 16:30: Colon cleansing 2 Club D
Georg Thieme Verlag KG Stuttgart · New York

RANDOMIZED STUDY SHOWS THAT SIMPLE, SPECIFIC VERBAL INSTRUCTIONS IMPROVE THE QUALITY OF BOWEL PREPARATION IN INPATIENTS UNDERGOING COLONOSCOPY

K Triantafyllou
1   Hepatogastroenterology Unit, Second Department of Internal Medicine – Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens, ''Attikon” University General Hospital, Athens, Greece
,
P Gkolfakis
1   Hepatogastroenterology Unit, Second Department of Internal Medicine – Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens, ''Attikon” University General Hospital, Athens, Greece
,
A Skamnelos
2   Division of Gastroenterology, University Hospital & Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
,
G Diamantopoulou
3   Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
,
A Dagas
4   Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
,
G Tziatzios
1   Hepatogastroenterology Unit, Second Department of Internal Medicine – Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens, ''Attikon” University General Hospital, Athens, Greece
,
K Thomopoulos
3   Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece
,
S Potamianos
4   Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larisa, Greece
,
D Christodoulou
2   Division of Gastroenterology, University Hospital & Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Bowel preparation for colonoscopy is often inadequate in hospitalized patients. We aimed to explore the effect of specific verbal instructions on the quality of inpatients bowel preparation.

Methods:

Randomized (1:1), two strata (ambulatory vs. bedridden; 3:2) trial of consecutive inpatients from 4 tertiary centers who received either specific, simple, verbal instructions (SSVI) about bowel preparation or the standard ward instructions (SI). Endoscopists were blinded. Mean BBPS score, very good (BBPS score≥7, no segment score< 2) and adequate (BBPS score≥6, no segment < 2) colon preparation comprised the study endpoints.

Results:

We enrolled 300 (180 ambulatory) inpatients; 155 (51.7%) men; aged 71.7 ± 15.1 years. 151 (50.3%) patients were randomized to the SI and 149 (49.7%) to the SSVI groups, respectively. We excluded 39 incomplete examinations due to bowel obstruction or patient intolerance. Overall, the mean BBPS score was significantly higher in the intervention group (6.74 ± 2.3 vs. 6.07 ± 2.4; p = 0.02), significantly more patients in the SSVI group achieved very good bowel preparation [75/129 (58.1%) vs. 57/132 (43.2%); OR (95% CI):1.83 (1.12 – 2.89)] and more patients in the SSVI group achieved adequate colon preparation [90/129 (69.8%) vs. 82/132 (62.1%); OR (95% CI):1.36 (0.81 – 2.28)] compared to those of SI. Among ambulatory patients, the mean BBPS score (7.2 ± 1.9 vs. 6.4 ± 2.1; p = 0.02), the rates of very good [67.9% vs. 45%; OR (95% CI): 2.59 (1.36 – 4.91)] and adequate [81.5% vs. 66.3%; OR (95% CI): 2.12 (1.02 – 4.39)] bowel preparation were significantly higher in the SSVI group. Among bedridden patients the benefit of provision of SSVI was not observed either on the mean BBPS score (6.06 ± 2.1 vs. 5.52 ± 2.8; p = 0.5) or on the rate of very good [41.7% vs. 40.4%; OR (95% CI): 1.05 (0.47 – 2.34)] or adequate [50% vs. 55.8%; OR (95% CI): 0.79 (0.36 – 1.74)] colon preparation.

Conclusions:

The quality of bowel preparation significantly increases by providing SSVI to inpatients. However, this effect is restricted among the ambulatory patients, while bedridden patients do not benefit from this intervention.