An endoscopist-blinded, randomized, controlled trial of a simple visual aid to improve bowel preparation for screening colonoscopy
An endoscopist-blinded, randomized, controlled trial of a simple visual aid to improve bowel preparation for screening colonoscopy
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DOI：
10.1016/j.gie.2010.10.013
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发表时间：
2011-02-01
影响因子：
7.7
通讯作者：
Jacobson, Brian C.
中科院分区：
文献类型：
--
作者：
Calderwood, Audrey H.;Lai, Edwin J.;Jacobson, Brian C.
背景：患者教育对结肠镜检查肠道准备的影响尚未得到充分研究。患者的改善：了解结肠镜检查前肠道准备的基本原理可能会增强对规定肠道治疗方案的依从性并提高肠道准备质量。目的：测量简单的教育干预对结肠镜检查期间肠道准备质量的影响。设计：前瞻性、单中心、内窥镜盲法、随机、对照试验。地点：三级护理中心。患者：本研究涉及 门诊患者直接转诊进行结肠镜检查筛查。干预：除了标准的书面结肠镜检查说明外，还包括描绘干净和肮脏结肠的视觉辅助工具。主要结果测量：主要结果是根据波士顿肠道准备量表（BBPS）的肠道准备质量。次要结果包括由于肠道准备不足而需要重复结肠镜检查、插入和取出时间、检测到息肉以及患者对肠道准备和结肠镜检查的耐受性。结果：我们分析了 492 名接受视觉辅助的患者和 477 名对照患者。两组中具有 BBPS 评分的结肠镜检查百分比相似（91% 视觉辅助 vs 89% 对照，P = 0.43）。与对照组相比，助视器组出现 BBPS 的比值比为 1.24（95% CI，0.83-1.87）。各组之间的其他次要结局相似。局限性：单中心研究。结论：一张带有照片和文字的简单卡片解释肠道准备的基本原理，并没有改变直接转诊进行结肠镜检查筛查的患者肠道准备的质量。未来的教育研究可能需要包括更多互动或强化的方法。 （临床试验注册号：NCIT00643682。）（Gastrointest Enclose 2011；73：307-14。）
Background: The effect of patient education on bowel preparation for colonoscopy has not been well studied. An improvement in patient: understanding of the rationale for bowel preparation before colonoscopy might enhance adherence to the prescribed bowel regimen and improve bowel preparation quality.Objective: To measure the effect of a simple educational intervention on the quality of bowel preparation during colonoscopy.Design: Prospective, single-center, endoscopist-blinded, randomized, controlled trial.Setting: Tertiary-care center.Patients: This study involved outpatients directly referred for screening colonoscopy.Intervention: Inclusion of a visual aid depicting both clean and dirty colons in addition to standard written colonoscopy instructions.Main Outcome Measurements: The primary outcome was the quality of the bowel preparation according to the Boston Bowel Preparation Scale (BBPS). Secondary outcomes included the need for repeat colonoscopy because of inadequate bowel preparation, insertion and withdrawal time, polyps detected, and patient tolerance of bowel preparation and colonoscopy.Results: We analyzed 492 patients given a visual aid and 477 controls. The percentage of colonoscopies with a BBPS score was similar in both groups (91% visual aid vs 89% control, P = .43). The odds ratio for having a BBPS in the visual aid group was 1.24 (95% CI, 0.83-1.87) compared with controls. Other secondary outcomes were similar between groups.Limitations: Single-center study.Conclusion: A simple card with photographs and text explaining the rationale for bowel preparation did not change the quality of bowel preparation in patients directly referred for screening colonoscopy. Future educational studies may need to include more interactive or intensive methods. (Clinical trial registration number: NCIT00643682.) (Gastrointest Enclose 2011;73:307-14.)