Abstract

CARVALHO, Rita et al. Randomized clinical trial to analyze the impact of personal education on bowel preparation for colonoscopy: preliminary results. J Port Gastrenterol. [online]. 2012, vol.19, n.4, pp.183-189. ISSN 0872-8178.

Introduction: The effectiveness of colonoscopy depends on adequate and careful examination of the entire colonic mucosa. Inadequate bowel preparation is a common problem on our daily clinical practice, affecting approximately 20% of all examinations. Objective: To analyze the impact that personal education could have on quality of bowel preparation for colonoscopy. Methods: During 24 months a prospective study was performed, randomized and blinded to the investigators. A computerized table was used for randomization and patients were allocated into two groups (control group and intervention group). All patients received oral information by their gastroenterologist and in the intervention group patients were given additionally personal education by a nurse. Patients referred for total colonoscopy were included with the exception of those with prior colonic surgery or diagnosis of colorectal cancer. The bowel preparation used was 4 liters of polyethylene glycol solution and the examination was performed without anesthesia, by two gastroenterologists. Patient’s data were analyzed and a questionnaire was applied after the examination. The grade of intestinal preparation was evaluated using the Aronchick preparation assessment scale. Correlation between investigators was calculated using Kappa method and the statistical analysis between the groups performed using t-Student and chi-squared tests. Results: 125 patients were randomized, 67 in control group and 58 in intervention group. Groups were homogeneous for almost all study variables with the exception of prior abdominal surgery and prior colonoscopy. An excellent or good bowel preparation was achieved in 38.8% of the exams in control group and in 58.6% in the intervention group, achieving statistical significance (p = 0.03). In subgroup analysis we also verified a better quality of bowel preparation in patients with chronic constipation (excellent or good bowel preparation: 21.4% in control group Vs. 57.1% in intervention group, p = 0.04). Conclusions: These results, although preliminary, suggest that the personal education could have a positive impact in improving quality of bowel preparation, particularly in some groups of patients as those with chronic constipation.

Keywords : Colonoscopy; Bowel preparation; Personal education.

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