Fabrizio Raffaello Parente1, Alessandro Repici2, Cristiano Crosta3, Livio Cipolletta4, Pier Alberto Testoni5, Guido Costamagna6, Angelo Andriulli7, Giovanni Di Matteo8, Remo Sassatelli9, Silvano Gallus10. 1. Gastroenterological Units, Ospedale A. Manzoni, Lecco, Italy. Electronic address: f.parente@ospedale.lecco.it. 2. IRCCS Humanitas, Rozzano, Italy. 3. Istituto Europeo di Oncologia, Milano, Italy. 4. Ospedale Maresca, Torre del Greco, Italy. 5. IRCCS San Raffaele, Milano, Italy. 6. Policlinico A. Gemelli, Roma, Italy. 7. IRCCS Casa del Sollievo e della Sofferenza, San Giovanni Rotondo, Italy. 8. Ospedale S. De Bellis, Castellana Grotte, Italy. 9. Azienda Ospedaliera di Reggio Emilia, Italy. 10. Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy.
Abstract
BACKGROUND & AIMS: The recent enormous increase in colonoscopy demand prompted this multicentre observational study assessing overall acceptability and efficacy of commonly used bowel preparations in Italian clinical practice. METHODS:Consecutive outpatients undergoing colonoscopy were recruited from 9 major gastroenterological centres in Italy. Each patient evaluated overall acceptability of the bowel cleansing preparation through a 0-100mm Visual Analogue Scale. The Visual Analogue Scale score was dichotomized by a median split: 80-100 (high acceptability) vs. 0-79 (low acceptability). Bowel cleansing was assessed through a validated scale. The influence of potential individual determinants on patients' acceptability and cleansing efficacy of the bowel preparations was determined by multivariate analyses. RESULTS:599 evaluable patients were enrolled; 57.3% received4L-PEG preparations, 29.5% 2L-PEG preparations and 13.2% 2-glasses-solutions (Na-phosphate/Mg-citrate/Na-picosulphate-containing preparations). Overall acceptability was significantly higher for 2L-PEG and 2-glasses solutions than 4L-PEG (adjusted odds ratio, 4.72; and adjusted odds ratio 2.07, respectively). Successful bowel cleansing achieved with 4L-PEG (85.9%) was similar to 2L-PEG (85.3%; adjusted odds ratio 0.82) and significantly higher than 2-glasses solutions (69.6%; adjusted odds ratio 0.34 vs. 4L-PEG). Split regimen, lower total preparation volume and colonoscopy reason (periodical control vs. 1st procedure) were significantly associated with high acceptability. Age ≥60 years, dissatisfaction with the preparation taken, and ≤4/week bowel movements were major determinants of a poor bowel cleansing. CONCLUSIONS: 2L-PEG and 4L-PEG preparations provide the most effective bowel cleansing for colonoscopy in clinical practice, with a significantly higher acceptability for 2L-PEG preparations.
RCT Entities:
BACKGROUND & AIMS: The recent enormous increase in colonoscopy demand prompted this multicentre observational study assessing overall acceptability and efficacy of commonly used bowel preparations in Italian clinical practice. METHODS: Consecutive outpatients undergoing colonoscopy were recruited from 9 major gastroenterological centres in Italy. Each patient evaluated overall acceptability of the bowel cleansing preparation through a 0-100mm Visual Analogue Scale. The Visual Analogue Scale score was dichotomized by a median split: 80-100 (high acceptability) vs. 0-79 (low acceptability). Bowel cleansing was assessed through a validated scale. The influence of potential individual determinants on patients' acceptability and cleansing efficacy of the bowel preparations was determined by multivariate analyses. RESULTS: 599 evaluable patients were enrolled; 57.3% received 4L-PEG preparations, 29.5% 2L-PEG preparations and 13.2% 2-glasses-solutions (Na-phosphate/Mg-citrate/Na-picosulphate-containing preparations). Overall acceptability was significantly higher for 2L-PEG and 2-glasses solutions than 4L-PEG (adjusted odds ratio, 4.72; and adjusted odds ratio 2.07, respectively). Successful bowel cleansing achieved with 4L-PEG (85.9%) was similar to 2L-PEG (85.3%; adjusted odds ratio 0.82) and significantly higher than 2-glasses solutions (69.6%; adjusted odds ratio 0.34 vs. 4L-PEG). Split regimen, lower total preparation volume and colonoscopy reason (periodical control vs. 1st procedure) were significantly associated with high acceptability. Age ≥60 years, dissatisfaction with the preparation taken, and ≤4/week bowel movements were major determinants of a poor bowel cleansing. CONCLUSIONS:2L-PEG and 4L-PEG preparations provide the most effective bowel cleansing for colonoscopy in clinical practice, with a significantly higher acceptability for 2L-PEG preparations.
Authors: Seung-Joo Nam; Young Jin Kim; Bora Keum; Jae Min Lee; Seung Han Kim; Hyuk Soon Choi; Eun Sun Kim; Yeon Seok Seo; Yoon Tae Jeen; Hong Sik Lee; Hoon Jai Chun; Soon Ho Um; Chang Duck Kim Journal: Medicine (Baltimore) Date: 2018-10 Impact factor: 1.817
Authors: Gabriel Perreault; Adam Goodman; Sebastian Larion; Ahana Sen; Kirsten Quiles; Michael Poles; Renee Williams Journal: Ann Gastroenterol Date: 2018-03-28