IDDF2021-ABS-0120 Face-to-face instruction and personalized bowel preparation regimens improve quality of preparation for inpatient colonoscopy: a randomized controlled trial

Abstract

<h3>Background</h3> Poor bowel preparation (BP) is commonly observed in inpatients undergoing colonoscopy, particularly those with a higher risk for inadequate BP. The objective of this study was to determine whether face-to-face instruction (FFI) and personalized BP regimens could improve the quality of BP for inpatient colonoscopy procedures. <h3>Methods</h3> In this endoscopist-blinded, randomized controlled trial, 320 inpatients were enrolled and randomly allocated at a ratio of 1:1 to the control and intervention groups. The intervention group received FFI and personalized BP regimes, while the control group received the standard education and BP regimes. The primary outcome was an adequate BP rate. Secondary outcomes included rates of procedure-related adverse events, incorrect diet restriction and laxative intake, quality of sleep before colonoscopy and willingness to repeat the BP. <h3>Results</h3> Demographic characteristics were comparable between the control and intervention groups. Notably, the adequate BP rate in the FFI group was significantly higher compared to the control group [intention-to-treat (ITT) analysis: 70.0% vs. 51.3%, <i>P</i> &lt; 0.001; per-protocol (PP) analysis: 79.4% vs. 58.6%, <i>P</i> &lt; 0.001;<b> (</b>IDDF2021-ABS-0120 Figure 1. The rate of adequate BP between the FFI and control groups for inpatients following ITT and PP analyses). Bowel cleanliness was significantly improved in response to the intervention in high-risk inpatients (ITT analysis: 65% vs. 44.6%,<i> P =</i> 0.004; PP analysis: 73.0% vs. 51.7%,<i> P =</i> 0.004) and in low-risk inpatients (ITT analysis: 80% vs. 62.7%,<i> P =</i> 0.037; PP analysis: 92.3% vs. 69.8% <i>P</i><i> =</i> 0.003). There were no significant differences between the control and intervention groups regarding secondary outcomes. <h3>Conclusions</h3> FFI and personalized BP regimens improve the rate of adequate BP, especially in patients with a higher risk for inadequate BP. As such, inpatients would benefit from this novel approach for better BP to ultimately improve the quality of colonoscopies.