Educational nurse-led telephone intervention shortly before colonoscopy as a salvage strategy after previous bowel preparation failure : a multicenter randomized trial
Álvarez-González, Marco Antonio (Institut Hospital del Mar d'Investigacions Mèdiques)
Pantaleón Sánchez, Miguel Ángel (Universitat Autònoma de Barcelona. Departament de Medicina)
Bernad Cabredo, Belén (Hospital Universitario de Burgos)
García-Rodríguez, Ana (Hospital de Viladecans (Viladecans, Catalunya))
Frago Larramona, Santiago (Department of Digestive Diseases, Hospital Santa Bárbara, Soria, Spain)
Nogales, Oscar (Hospital General Universitario Gregorio Marañón)
Díez Redondo, Pilar (Hospital Universitario Río Hortega (Valladolid))
Puig del Castillo, Ignasi (Altahia Xarxa Asistencial Universitaria de Manresa. Departament de Malalties Digestives)
Romero Mascarell, Cristina (Consorci Sanitari Hospital de Terrassa)
Caballero, Noemí (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Romero Sánchez-Miguel, Iván (Hospital Universitario 12 de Octubre (Madrid))
Pérez Berbegal, Rocío (Hospital del Mar (Barcelona, Catalunya))
Hernández Negrín, Domingo (Hospital Universitario de Canarias (La Laguna))
Bujedo Sadornill, Gema (Hospital Universitario de Burgos)
Pérez Oltra, Alicia (Hospital de Viladecans (Viladecans, Catalunya))
Casals Urquiza, Gemma (Hospital del Mar (Barcelona, Catalunya))
Amorós Martínez, Jaume (Universitat Oberta de Catalunya)
Seoane Urgorri, Agustín (Institut Hospital del Mar d'Investigacions Mèdiques)
Ibáñez Zafón, Inés Ana (Hospital del Mar (Barcelona, Catalunya))
Gimeno-García, Antonio Z. (Hospital Universitario de Canarias (La Laguna))

Date:	2020
Abstract:	Background The most important predictor of unsuccessful bowel preparation is previous failure. For those patients with previous failure, we hypothesized that a nurse-led educational intervention by telephone shortly before the colonoscopy appointment could improve cleansing efficacy. Methods We performed a multicenter, endoscopist-blinded, randomized controlled trial. Consecutive outpatients with previous inadequate bowel preparation were enrolled. Both groups received the same standard bowel preparation protocol. The intervention group also received reinforced education by telephone within 48 hours before the colonoscopy. The primary outcome was effective bowel preparation according to the Boston Bowel Preparation Scale. Intention-to-treat (ITT) analysis included all randomized patients. Per-protocol analysis included patients who could be contacted by telephone and the control cases. Results 657 participants were recruited by 11 Spanish hospitals. In the ITT analysis, there was no significant difference between the intervention and control groups in the rate of successful bowel preparation (77. 3 % vs. 72 %; P = 0. 12). In the intervention group, 267 patients (82. 9 %) were contacted by telephone. Per-protocol analysis revealed significantly improved bowel preparation in the intervention group (83. 5 % vs. 72. 0 %; P = 0. 001). Conclusion Among all patients with previous inadequate bowel preparation, nurse-led telephone education did not result in a significant improvement in bowel cleansing. However, in the 83 % of patients who could be contacted, bowel preparation was substantially improved. Phone education may therefore be a useful tool for improving the quality of bowel preparation in those cases.
Note:	Altres ajuts: This study was supported by grants from the Asociación Española de Gastroenterología and the Societat Catalana de Digestología.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Endoscopy, Vol. 52 (june 2020) , p. 1026-1035, ISSN 1438-8812

DOI: 10.1055/a-1178-9844
PMID: 32557475

10 p, 1000.8 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles