School of Medicine, Ningbo University, Ningbo, 315211, Zhejiang, China.
Department of Gastroenterology, Ningbo First Hospital, Ningbo, 315010, Zhejiang, China.
Dig Dis Sci. 2022 Aug;67(8):3592-3600. doi: 10.1007/s10620-021-07290-x. Epub 2021 Oct 27.
Poor bowel preparation is commonly observed in inpatients undergoing colonoscopy, particularly those with higher risks for inadequate bowel preparation.
The objective of this study was to determine whether personalized bowel preparation regimens combined with face-to-face instruction (FFI) could improve the quality of bowel preparation for inpatient.
In this endoscopist-blinded, randomized controlled trial, 320 inpatients were enrolled and randomly allocated (1:1) to the control and intervention groups. The intervention group received FFI and personalized bowel preparation regimens, while the control group received the routine bowel preparation regimen and education. The primary outcome was adequate bowel preparation rate. Secondary outcomes included rates of procedure-related adverse events, incorrect diet restriction and laxative intake, etc. RESULTS: The adequate bowel preparation rate in the intervention group was significantly higher compared to control group [intention-to-treat (ITT) analysis: 70.0% vs 51.3%, P < 0.001; per-protocol (PP) analysis: 79.4% vs 58.6%, P < 0.001]. Bowel cleanliness was significantly improved in high-risk inpatients (ITT analysis: 65% vs 44.6%, P = 0.004; PP analysis: 73.0% vs 51.7%, P = 0.004) and in low-risk inpatients (ITT analysis: 80% vs 62.7%, P = 0.037; PP analysis: 92.3% vs 69.8%, P = 0.003). There were no significant differences between two groups regarding procedure-related adverse events.
Personalized bowel preparation regimens combined with FFI improve the rate of adequate bowel preparation, especially for patients with high-risk factors. As such, inpatients could benefit from this novel approach for better bowel preparation to ultimately improve the quality of colonoscopies.
接受结肠镜检查的住院患者常出现肠道准备不佳的情况，尤其是那些肠道准备不佳风险较高的患者。
本研究旨在确定个体化肠道准备方案联合面对面指导（FFI）是否可以提高住院患者的肠道准备质量。
这是一项内镜医师设盲、随机对照试验，共纳入 320 名住院患者，按 1:1 比例随机分配至对照组和干预组。干预组接受 FFI 和个体化肠道准备方案，对照组接受常规肠道准备方案和教育。主要结局为肠道准备充分率。次要结局包括与操作相关的不良事件、饮食限制和泻药摄入不当的发生率等。
干预组的肠道准备充分率明显高于对照组[意向治疗（ITT）分析：70.0%比 51.3%，P<0.001；符合方案（PP）分析：79.4%比 58.6%，P<0.001]。高危住院患者的肠道清洁度明显改善（ITT 分析：65%比 44.6%，P=0.004；PP 分析：73.0%比 51.7%，P=0.004）和低危住院患者（ITT 分析：80%比 62.7%，P=0.037；PP 分析：92.3%比 69.8%，P=0.003）。两组在与操作相关的不良事件方面无显著差异。
个体化肠道准备方案联合 FFI 可提高肠道准备充分率，尤其是对高危因素患者。因此，这种新方法可使住院患者受益，更好地进行肠道准备，从而提高结肠镜检查的质量。
