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
研究概览
地位
详细说明
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.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Prasad Mothayapan, MD
- 电话号码:+60-84-343333
- 邮箱:mprasad.ge@gmail.com
学习地点
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Sarawak
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Sibu、Sarawak、马来西亚、96000
- 招聘中
- Hospital Sibu
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:支持治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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有源比较器: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.
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Standard verbal instructions delivered by physician or nurse regarding bowel preparation regimen, timing, dietary restrictions, and what to expect during procedure.
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实验性的: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.
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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.
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实验性的: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.
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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.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Adequate Bowel Preparation on Boston Bowel Preparation Scale (BBPS)
大体时间:On day of colonoscopy procedure, assessed immediately upon colonoscope insertion before lavage (time point: 0 minutes)
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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.
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On day of colonoscopy procedure, assessed immediately upon colonoscope insertion before lavage (time point: 0 minutes)
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Polyp Detection Rate
大体时间:During colonoscopy procedure
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Proportion of participants with at least one polyp detected during colonoscopy.
Documented as yes/no and number of polyps.
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During colonoscopy procedure
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Cecal Intubation Time
大体时间:During colonoscopy procedure
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Time in minutes from colonoscope insertion to identification of cecal landmarks.
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During colonoscopy procedure
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Colonoscopy Withdrawal Time
大体时间:During colonoscopy procedure
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Time in minutes from initiation of scope withdrawal to scope exit at rectum, excluding biopsy/therapeutic time.
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During colonoscopy procedure
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Procedure Cancellation Rate
大体时间:On day of scheduled colonoscopy
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Proportion of participants whose colonoscopy was cancelled and reason for cancellation.
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On day of scheduled colonoscopy
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Repeat Colonoscopy Rate
大体时间:Within 6 months of initial colonoscopy
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Proportion requiring repeat colonoscopy due to inadequate initial preparation.
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Within 6 months of initial colonoscopy
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Patient Tolerance to Bowel Preparation
大体时间:Pre-procedure on day of colonoscopy
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atient self-reported tolerability using five-point scale: Very Easy, Easy, Neutral, Difficult, Very Difficult.
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Pre-procedure on day of colonoscopy
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Patient Anxiety Assessment
大体时间:Pre-procedure on day of colonoscopy
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Patient self-reported anxiety on Visual Analog Scale for Anxiety (VAS-A), 0-10 scale (0=no anxiety, 10=extremely anxious).
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Pre-procedure on day of colonoscopy
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Procedure-Related Complications
大体时间:During procedure and within 7 days post-procedure
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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.
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During procedure and within 7 days post-procedure
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Patient-Reported Clarity of Instructions
大体时间:Pre-procedure on day of colonoscopy
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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).
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Pre-procedure on day of colonoscopy
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合作者和调查者
调查人员
- 首席研究员:Prasad Mothayapan, MD、Hospital Sibu, Malaysia
- 研究主任:Tiong How Chieng, MD、Hospital Sibu, Malaysia
出版物和有用的链接
研究记录日期
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学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
其他研究编号
- RSCH-25-05992-BBX
- NMRR-25-04038-EOB (注册表标识符:Malaysian National Medical Research Registry)
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