Bowel Preparation Quality Following Video-Based Intervention and Educational Booklet Versus Standard of Care in an Outpatient Setting (PrepVibe)
Bowel Preparation Quality Following Video-Based Intervention and Educational Booklet Versus Standard of Care in an Outpatient Setting: A Single-Center, Endoscopist-Blinded Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
BACKGROUND AND RATIONALE:
Non-pharmacological factors, especially the modality of patient education, may influence bowel preparation quality, yet are underexplored and likely context-dependent based on local staffing, patient characteristics, and practice norms.
STUDY DESIGN:
Prospective, single-endoscopist-blinded, three-arm randomized controlled trial (RCT) with intention-to-treat (ITT) primary analysis. Allocation 1:1:1 using computer-generated random numbers. Endoscopist and endoscopy nurses are blinded to group assignment; participants cannot be blinded due to the nature of the intervention.
SETTING:
Hospital Sibu Endoscopy Unit, Sarawak, Malaysia. Colonoscopies performed by qualified surgeons or registrars under supervision; all endoscopists undergo refresher training on Boston Bowel Preparation Scale (BBPS) scoring for consistency.
STUDY ARMS (INTERVENTIONS):
Arm A (Control): Usual care. Physician/nurse-delivered verbal instructions plus standard pharmacy instructions for bowel preparation solution (split-dose PEG 3L).
Arm B (Written): Tri-lingual (Malay/English/Chinese), plain-language educational leaflet reviewed by health literacy expert, plus brief verbal explanation. Arm C (Visual): Short, structured instructional videos accessible via smartphone QR code, reviewed by health literacy expert, plus brief verbal explanation.
SAMPLE SIZE AND STATISTICAL ANALYSIS:
N=324 (108 per arm). Primary analysis: Intent-to-treat chi-square test comparing adequate vs inadequate BBPS across three arms. Pairwise comparisons with Bonferroni adjustment. Multivariable logistic regression adjusts for prespecified covariates (age, sex, BMI, diabetes, education, language, constipation, study arm).
PRIMARY OUTCOME:
Adequate versus inadequate bowel preparation on Boston Bowel Preparation Scale (BBPS). Adequate = total ≥6 with all segments ≥2.
SECONDARY OUTCOMES:
Polyp detection rate; cecal intubation and withdrawal times; cancellation and repeat rates; patient tolerance; complications; patient-reported clarity and helpfulness; anxiety (VAS-A); demographic predictors.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Prasad Mothayapan, MD
- Phone Number: +60-84-343333
- Email: mprasad.ge@gmail.com
Study Locations
-
-
Sarawak
-
Sibu, Sarawak, Malaysia, 96000
- Recruiting
- Hospital Sibu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 years or older
- Outpatients scheduled for elective colonoscopy at Hospital Sibu Endoscopy Unit
- Ability to provide written informed consent
- Access to smartphone or computer with functional internet connectivity
Exclusion Criteria:
- History of non-compliance with prescribed medical regimens
- Cognitive impairment, dementia, or significant mental health disorder compromising informed consent
- Illiteracy or inability to read materials in provided languages
- Prior colonic resection or colostomy
- Inflammatory Bowel Disease (IBD) or Irritable Bowel Syndrome (IBS)
- Significant physical disability (bed-bound or wheelchair-dependent)
- Contraindication to polyethylene glycol (PEG) bowel preparation
- Severe Chronic Kidney Disease (Stage IV or V; eGFR <15 mL/min/1.73m²)
- Significant cardiac comorbidities (unstable angina, severe heart failure, MI within 6 months)
- Inability or unwillingness to comply with study protocol
- Refusal to provide informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Usual Care (Verbal Counseling)
Standard physician/nurse-delivered verbal instructions and standard pharmacy information sheet for bowel preparation solution (split-dose PEG 3L, Fortrans) according to hospital protocol.
Timing and dietary guidance aligned with standard of care.
No additional written or visual materials provided.
|
Standard verbal instructions delivered by physician or nurse regarding bowel preparation regimen, timing, dietary restrictions, and what to expect during procedure.
|
|
Experimental: Written Educational Pamphlet
Tri-lingual (Malay, English, Chinese) plain-language educational pamphlet detailing step-by-step bowel preparation instructions, plus brief verbal explanation.
Pamphlet reviewed by health literacy expert prior to use.
Same preparation solution and regimen as Control arm.
|
Structured written educational material in Malay, English, and Chinese languages detailing complete bowel preparation instructions, timing, dietary guidance, what to expect, and troubleshooting tips.
Provided to participant with brief verbal explanation.
|
|
Experimental: Visual Media (QR Code Video)
Short, structured instructional videos accessible via smartphone QR code explaining bowel preparation procedure step-by-step, plus brief verbal explanation.
Videos reviewed by health literacy expert prior to use.
Same preparation solution and regimen as Control arm.
|
Short, professionally produced instructional videos accessible via smartphone QR code link.
Videos present step-by-step bowel preparation instructions, timing, dietary guidance, common concerns, and what to expect during procedure.
Participant scans QR code to access video(s) on their smartphone.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Adequate Bowel Preparation on Boston Bowel Preparation Scale (BBPS)
Time Frame: On day of colonoscopy procedure, assessed immediately upon colonoscope insertion before lavage (time point: 0 minutes)
|
Primary outcome dichotomized as adequate versus inadequate bowel preparation.
Adequate = total BBPS score ≥6 with all three colon segments (left, transverse, right) scoring ≥2 each (scale 0-3 per segment; range 0-9).
Inadequate = total <6 or any segment <2.
Assessment performed before any bowel cleansing/lavage.
|
On day of colonoscopy procedure, assessed immediately upon colonoscope insertion before lavage (time point: 0 minutes)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Polyp Detection Rate
Time Frame: During colonoscopy procedure
|
Proportion of participants with at least one polyp detected during colonoscopy.
Documented as yes/no and number of polyps.
|
During colonoscopy procedure
|
|
Cecal Intubation Time
Time Frame: During colonoscopy procedure
|
Time in minutes from colonoscope insertion to identification of cecal landmarks.
|
During colonoscopy procedure
|
|
Colonoscopy Withdrawal Time
Time Frame: During colonoscopy procedure
|
Time in minutes from initiation of scope withdrawal to scope exit at rectum, excluding biopsy/therapeutic time.
|
During colonoscopy procedure
|
|
Procedure Cancellation Rate
Time Frame: On day of scheduled colonoscopy
|
Proportion of participants whose colonoscopy was cancelled and reason for cancellation.
|
On day of scheduled colonoscopy
|
|
Repeat Colonoscopy Rate
Time Frame: Within 6 months of initial colonoscopy
|
Proportion requiring repeat colonoscopy due to inadequate initial preparation.
|
Within 6 months of initial colonoscopy
|
|
Patient Tolerance to Bowel Preparation
Time Frame: Pre-procedure on day of colonoscopy
|
atient self-reported tolerability using five-point scale: Very Easy, Easy, Neutral, Difficult, Very Difficult.
|
Pre-procedure on day of colonoscopy
|
|
Procedure-Related Complications
Time Frame: During procedure and within 7 days post-procedure
|
Occurrence of perforation, bleeding, post-polypectomy syndrome, or other adverse events.
|
During procedure and within 7 days post-procedure
|
|
Patient-Reported Clarity of Instructions
Time Frame: Pre-procedure on day of colonoscopy
|
Patient perception of clarity using five-point Likert scale.
Statement: "The instructions were clear."
|
Pre-procedure on day of colonoscopy
|
|
Patient Anxiety Assessment
Time Frame: Pre-procedure on day of colonoscopy
|
Patient self-reported anxiety on Visual Analog Scale for Anxiety (VAS-A), 0-10 scale (0=no anxiety, 10=extremely anxious).
|
Pre-procedure on day of colonoscopy
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Prasad Mothayapan, MD, Hospital Sibu, Malaysia
- Study Director: Tiong How Chieng, MD, Hospital Sibu, Malaysia
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
Other Study ID Numbers
- RSCH-25-05992-BBX
- NMRR-25-04038-EOB (Registry Identifier: Malaysian National Medical Research Registry)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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