1
|
Huang X, Yang L, Lyu Y, Ma H, Zhou X, Ye K, Feng J. Dried lemon slices improve bowel cleansing quality of polyethylene glycol for colonoscopy preparation: randomized controlled trial. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2024; 116:7-13. [PMID: 37539523 DOI: 10.17235/reed.2023.9676/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND adequate bowel preparation is related to the quality of colonoscopy. Dried lemon slices can increase gastrointestinal peristalsis, which has shown potential as an adjuvant of bowel preparation. We hypothesized that the combination of dried lemon slices and polyethylene glycol (PEG) could improve the efficacy of bowel preparation and be more acceptable to participants. AIM to investigate the effectiveness of lemon slices combined with PEG for colonoscopy preparation. METHODS a prospective, single-center, randomized, controlled trial was performed of 521 patients randomly assigned to two groups. A total of 254 patients were given lemon slices based on conventional 4-L PEG treatment for the bowel, while 267 patients received only 4-L PEG treatment. Patients' basic information, procedure-related parameters, adverse effects, and subjective feelings were collected by questionnaires. Intestinal tract cleanliness was scored according to the Boston Bowel Preparation Scale (BBPS) by experienced endoscopists. Data were analyzed by the two-sample t-test or the Chi-squared test. RESULTS the BBPS scores were significantly higher in the PEG + lemon slice group (p < 0.05). The taste acceptability, satisfaction, and willingness to repeat bowel preparation were significantly higher in the PEG+ lemon slice group (p < 0.05). However, a larger proportion of patients from the PEG+ lemon slice group (30.7 %) suffered abdominal distension compared with the PEG group (20.6 %), while the incidence of other adverse effects was comparable between the two groups. CONCLUSION the addition of dried lemon slices to conventional PEG showed its superiority for bowel preparation.
Collapse
Affiliation(s)
- Xiawei Huang
- Nursing, The First Affiliated Hospital. College of Medicine. Zhejiang University
| | - Liping Yang
- Gastroenterology, The First Affiliated Hospital. College of Medicine. Zhejiang University
| | - Yingbo Lyu
- Gastroenterology, The First Affiliated Hospital. College of Medicine. Zhejiang University
| | - Han Ma
- Gastroenterology, The First Affiliated Hospital. College of Medicine. Zhejiang University
| | - Xiaoli Zhou
- Gastroenterology, The First Affiliated Hospital. College of Medicine. Zhejiang University
| | - Kexin Ye
- Gastroenterology, The First Affiliated Hospital. College of Medicine. Zhejiang University
| | - Jiehui Feng
- Nursing, The First Affiliated Hospital. College of Medicine. Zhejiang University, China
| |
Collapse
|
2
|
Chen BR, Zhang LH, Shi ZH, Ding XW, Liu Y, Wang AX, Chen ZF, Yao LW, Gong RR, Wang JX, Wu LL, Liu J, Yu HG. Preoperative automatic reminder systems and impact on quality and compliance with colonoscopy preparation: A multicenter randomized controlled trial. J Dig Dis 2023; 24:530-539. [PMID: 37610349 DOI: 10.1111/1751-2980.13222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES Traditional preoperative reminding services have been applied to enhance the quality of bowel preparation for colonoscopy. In this study we aimed to evaluate the effectiveness of an automated electronic reminder system (E-reminder) on improving bowel preparation and the quality of preoperative education before colonoscopy. METHODS From August 2021 to March 2022, 833 outpatients aged 50-75 years who underwent colonoscopy were included and randomly assigned to the E-reminder group and the control group. While the control group received routine preoperative education. The E-reminder group received automatic phone call, text message reminders and web services regarding the details of bowel preparation before the colonoscopic examination. The quality of bowel preparation was evaluated by the Boston Bowel Preparation Scale (BBPS) score and the previously validated objective evaluation scale of automatic BBPS (e-BBPS). RESULTS In manual assessment, the rate of adequate bowel preparation was improved in the E-reminder group of intention-to-treat population using BBPS (60.7% vs 54.5%, P = 0.01). The percentage of objective evaluated adequate bowel preparation using e-BBPS in the E-reminder group of per-protocol population was significantly higher than that in the control group (76.9% vs 69.2%, P = 0.02). CONCLUSIONS E-reminder was an effective tool to improve the quality of bowel preparation and compliance with medical instructions. It may be regarded as an efficient and convenient education tool, improving the quality of medical service.
Collapse
Affiliation(s)
- Bo Ru Chen
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Li Hui Zhang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Zhao Hong Shi
- Department of Gastroenterology, Wuhan No. 1 Hospital, Wuhan, Hubei Province, China
| | - Xiang Wu Ding
- Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hubei Province, China
| | - Yi Liu
- Department of Gastroenterology, Wuhan No. 1 Hospital, Wuhan, Hubei Province, China
| | - Ai Xiang Wang
- Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hubei Province, China
| | - Zu Fang Chen
- Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hubei Province, China
| | - Li Wen Yao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Rong Rong Gong
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Jun Xiao Wang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Lian Lian Wu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Jun Liu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Hong Gang Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| |
Collapse
|
3
|
Lim TZ, Lau J, Wong GJ, Tan LYT, Chang YJ, Natarajan K, Yi H, Wong ML, Tan KK. Factors predicting improved compliance towards colonoscopy in individuals with positive faecal immunochemical test (FIT). Cancer Med 2021; 10:7735-7746. [PMID: 34519182 PMCID: PMC8559494 DOI: 10.1002/cam4.4275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 01/15/2023] Open
Abstract
Objectives Follow‐up colonoscopy after a positive faecal immunochemical test (FIT) in any colorectal cancer (CRC) screening programme is integral. However, many individuals who had a positive FIT declined colonoscopy subsequently. This study aims to uncover the predictors on completion of colonoscopy using the Health Belief Model (HBM) between individuals who complete and those who did not after a positive FIT. Methods A mixed‐method study comprising qualitative semi‐structured interviews followed by a locally validated questionnaire in Singapore was prospectively administered via telephone interview to average risk individuals with positive FIT results from a cohort of the national FIT screening database referred for follow‐up colonoscopic evaluation. Results A total of 394 individuals, with a median age of 66 years (range, 46–89 years), were recruited. Fifty percent completed follow‐up colonoscopic evaluation and formed the “doers” group. All participants demonstrated high knowledge of symptoms of CRC and awareness and qualitative responses were aligned to the various HBM domains. Using multi‐variable analysis, doers felt that medical recommendations (odds ratio [OR], 2.39, 95% confidence interval [CI]: 1.23–4.63, p = 0.01) and mainstream media publicity (OR, 2.16, 95% CI: 1.09–4.26, p = 0.026) were important. Non‐doers showed positive association with perceived barriers such as cost (OR, 2.15, 95% CI: 1.10–4.20, p = 0.026) and inconvenience (OR, 3.44, 95% CI: 1.50–7.89, p = 0.004). Conclusions Identified factors such as tackling perceived barriers, public health education and active promotion by medical physicians, family and friends could help guide subsequent interventions to improve compliance of individuals with positive FIT to undergo follow‐up colonoscopy. Only a third of FIT‐positive individuals go for follow‐up colonoscopy in Singapore. This is an Asian study comparing knowledge and attitudes of compliant and non‐compliant FIT‐positive individuals towards follow‐up colonoscopy.
Collapse
Affiliation(s)
- Tian-Zhi Lim
- Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Jerrald Lau
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Gretel Jianlin Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Lavine Yen-Ting Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yu-Jing Chang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Karthiga Natarajan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Mee-Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ker-Kan Tan
- Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore.,Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
4
|
Liu C, Song X, Hao H. Educational Video Followed by Retelling Bowel Preparation Process to Improve Colonoscopy Bowel Preparation Quality: A Prospective Nursing Intervention Study. Med Sci Monit 2018; 24:6029-6037. [PMID: 30158512 PMCID: PMC6128185 DOI: 10.12659/msm.909572] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background This study investigated the effect of a patient education video followed by retelling the process of bowel preparation on colonoscopy bowel preparation quality. Material/Methods This was a prospective, randomized, controlled clinical trial of outpatients undergoing colonoscopy. Patients were randomized (1: 1) to the video + retelling group or the control group. The primary endpoint was to assess the bowel preparation quality using the Ottawa Bowel Preparation Quality scale (Ottawa score). Risk factors associated with poor bowel preparation were also evaluated. Result The video + retelling group had a higher percentage of patients with adequate colonoscopy bowel preparation (Ottawa score <6) than the control group (P<0.001). Mean Ottawa total scores significantly differed between the control group and the video + retelling group (4.18±1.4 vs. 3.05±1.3, P<0.001). The video + retelling group showed superior cleanliness in the right, middle, and recto-sigmoid colon segments (all Ps <0.001). Logistic regression analysis revealed that male gender (OR=2.10, 95%CI: 1.098–4.018, P=0.025), diabetes mellitus (OR=2.830, 95%CI: 1.257–6.372, P=0.012), and no educational video followed by retelling bowel preparation process (OR=3.02, 95%CI: 1.731–5.270, P<0.001) were independently associated with poor bowel preparation. Conclusions Use of an educational video followed by asking patients to retell the process of bowel preparation after receiving regular instructions is a convenient and risk-free practice that enhances the compliance with bowel preparation guidance and improves bowel preparation quality.
Collapse
Affiliation(s)
- Chunna Liu
- Department of Quality Management Division, Yantai City Hospital of Traditional Chinese Medicine, Yantai, Shandong, China (mainland)
| | - Xiaoyan Song
- Department of Emergency, Yantai City Hospital of Traditional Chinese Medicine, Yantai, Shandong, China (mainland)
| | - Huiqiu Hao
- Department of Neck, Shoulder, Waist, and Leg Pain, Yantai City Hospital of Traditional Chinese Medicine, Yantai, Shandong, China (mainland)
| |
Collapse
|