Preparation regimen is more important than patient-related factors: a randomized trial comparing a standard bowel preparation before colonoscopy with an individualized approach

Abstract

Background. Optimal bowel preparation is one of the most important factors affecting the quality of colonoscopy. Several patient-related factors are known to influence the quality of bowel cleansing but randomized trials in this area are lacking. We aimed to compare an individualized bowel prep strategy based on patient characteristics to a standard preparation regimen.Material and Methods. We conducted an endoscopist-blinded multicenter randomized control-trial. The Boston Bowel Prep Score (BBPS) was used to assess quality of bowel preparation and a 10 point visual analogue scale to assess patient comfort during bowel prep. Patients were randomised to either the standard regimens of split-dose 4L polyethylene-glycol (group A), split-dose sodium picosulphate/magnesium citrate (group B) or to either of the two depending on their responses to a 3-item questionnaire (individualized preparation, group C).Results. 185 patients were randomized during the study period and 143 patients were included in the final analysis. Patients in the individualized group had a median BBPS of 7 compared to a median of 6 in the standard group (p = 0.7). Also, there was no significant difference in patients' comfort scores, irrespective of study group or laxative regimen. However, on multivariable analysis, a split-dose 4L polyethylene-glycol was an independent predictor for achieving a BBPS>6 (OR 3.7, 95% CI 1.4-9.8), regardless of patient-related factors.Conclusion. The choice of laxative seems to be more important than patient-related factors in predicting bowel cleansing. Comfort during bowel prep is not influenced by the type of strategy used.

Double blinded randomized clinical trial to assess the effectiveness of several preparations for colonoscopy

“…11,12 Furthermore, solutions should be safe and e with acceptable patient tolerance. 15 Our results suggest that the ingestion of any of the four types of preparation is equally effective as for the quality of the cleansing of the colon. Out of the 117 tests performed, 103 (88%) had an appropriate score (≥6 in the Boston Bowel Preparation Scale), with no differences among groups (p = 0.271).…”

Tolerance to colonoscopy preparation with Fortrans and predictors of negative effects

“…В конечном итоге были получены аналогичные оценки удовлетворенности переносимостью подготовки в группах с одномоментной и раздельной подготовкой к колоноскопии. Т. Voiosu и соавт., применив 10-балльную визуальную аналоговую шкалу для оценки удовлетворенности пациента подготовкой очищения кишки, также отметили отсутствие различий в оценке комфорта в зависимости от способа ее подготовки [12]. L.А.…”

No inferioridad entre dos agentes de bajo volumen (Picosulfato de Sodio/Citrato de Magnesio vs. Sulfato de Sodio/Potasio/Magnesio) en la preparación de colon para procedimientos diagnósticos: estudio observacional

“…Para el colon izquierdo, el 48 % (n = 267) de pacientes con SPMC tuvo una adecuada limpieza con respecto al sulfato de sodio/potasio/magnesio (n = 288 [52]; OR: 1,65 [0,88-3,11]; p = 0,154); para el colon trasverso se evidenció un mejor resultado con SPMC (n = 273 [54 %]; OR: 2,11 [1,35]; p = 0,002); y para colon derecho los resultados fueron similares (n = 238 [52 %]; OR: 1,12 [0,74-1,71]; p = 0,583) (Tabla 4). Adicionalmente, se realizó una comparación de la cantidad de pacientes que obtuvo un puntaje de 0-1 en algún segmento del colon, pese a tener un puntaje global de BBPS ≥ 6 puntos.…”

“…El cáncer colorrectal (CCR) es un problema de salud pública (1). Según datos de la Organización Mundial de la Salud (OMS), se estimaron más de 1,8 millones de casos nuevos de CCR y 881 000 muertes para el 2018 a nivel global (2).…”