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
Обзор исследования
Статус
Статус
Условия
Условия
Вмешательство/лечение
Вмешательство/лечение
Подробное описание
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.
Тип исследования
Тип исследования
Регистрация (Оцененный)
Регистрация
Фаза
Фаза
- Непригодный
Контакты и местонахождение
Контакты исследования
Контакты исследования
- Имя: Prasad Mothayapan, MD
- Номер телефона: +60-84-343333
- Электронная почта: mprasad.ge@gmail.com
Места учебы
-
-
Sarawak
-
Sibu, Sarawak, Малайзия, 96000
- Рекрутинг
- Hospital Sibu
-
-
Критерии участия
Критерии приемлемости
Критерии приемлемости
Возраст, подходящий для обучения
- Взрослый
- Пожилой взрослый
Принимает здоровых добровольцев
Описание
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
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Поддерживающая терапия
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Двойной
Количество рук
Оружие и интервенции
Группа участников / АрмияГруппа участников / Армия |
Вмешательство/лечениеВмешательство/лечение |
|---|---|
|
Активный компаратор: 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.
|
|
Экспериментальный: 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.
|
|
Экспериментальный: 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.
|
Что измеряет исследование?
Первичные показатели результатов
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Adequate Bowel Preparation on Boston Bowel Preparation Scale (BBPS)
Временное ограничение: 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)
|
Вторичные показатели результатов
Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Polyp Detection Rate
Временное ограничение: 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
Временное ограничение: During colonoscopy procedure
|
Time in minutes from colonoscope insertion to identification of cecal landmarks.
|
During colonoscopy procedure
|
|
Colonoscopy Withdrawal Time
Временное ограничение: 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
Временное ограничение: On day of scheduled colonoscopy
|
Proportion of participants whose colonoscopy was cancelled and reason for cancellation.
|
On day of scheduled colonoscopy
|
|
Repeat Colonoscopy Rate
Временное ограничение: 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
Временное ограничение: 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
|
|
Patient Anxiety Assessment
Временное ограничение: 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
|
|
Procedure-Related Complications
Временное ограничение: During procedure and within 7 days post-procedure
|
Occurrence of procedure-related complications including perforation, bleeding, post-polypectomy syndrome, or other adverse events.
Outcome is dichotomous: Yes (complication occurred) or No (no complications).
Lower occurrence rate indicates better outcome.
|
During procedure and within 7 days post-procedure
|
|
Patient-Reported Clarity of Instructions
Временное ограничение: Pre-procedure on day of colonoscopy
|
Patient perception of clarity using Five-Point Likert Scale (minimum=1 "Strongly Disagree", maximum=5 "Strongly Agree").
Statement: "The instructions were clear."
Higher scores indicate greater perceived clarity of instructions (better outcome).
|
Pre-procedure on day of colonoscopy
|
Соавторы и исследователи
Спонсор
Спонсор
Следователи
Следователи
- Главный следователь: Prasad Mothayapan, MD, Hospital Sibu, Malaysia
- Директор по исследованиям: Tiong How Chieng, MD, Hospital Sibu, Malaysia
Публикации и полезные ссылки
Полезные ссылки
Даты записи исследования
Изучение основных дат
Начало исследования (Действительный)
Начало исследования
Первичное завершение (Оцененный)
Первичное завершение
Завершение исследования (Оцененный)
Завершение исследования
Даты регистрации исследования
Первый отправленный
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Первый опубликованный
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее опубликованное обновление
Последнее отправленное обновление, отвечающее критериям контроля качества
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Другие идентификационные номера исследования
Другие идентификационные номера исследования
- RSCH-25-05992-BBX
- NMRR-25-04038-EOB (Идентификатор реестра: Malaysian National Medical Research Registry)
Планирование данных отдельных участников (IPD)
Планируете делиться данными об отдельных участниках (IPD)?
Описание плана IPD
Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
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