A randomized control trial to assess the effectiveness of a brief educational intervention on colonoscopy preparation and experience in patients with inflammatory bowel disease

Abstract

Background: Colonoscopy is important for diagnosis, assessment and dysplasia screening in inflammatory bowel disease (IBD). A good bowel preparation is required for complete and adequate assessment. Trial design: Randomised, assessor blinded parallel arm trial with 1:1 allocation. Methods: Patients with IBD undergoing colonoscopy were randomised to control group (standard preparation with written instructions) or experimental group (additional brief video educational intervention). Outcome assessors and colonoscopist were masked to the allocation. Primary outcome was adequacy of bowel preparation (Boston bowel preparation score of ≥ 6). Results: Of 130 patients randomised, 107 (57% males, mean age 38.4 years, 84% with ulcerative colitis) were analysed. The groups were similar for baseline characters (age, gender, rural residence, educational status, duration of illness, IBD therapies, and endoscopic activity). Adequate bowel preparation was present similar numbers in experimental group compared to control group (43.1% versus 35%) (p = 0.43). The groups were similar for perfect preparation (7.8% versus 8.9%) (p = 0.84), worsening of disease activity (3.9% versus 3.7%) (p = 1.00), time to cecal intubation (240, 191 s versus 268, 228 s) (p = 0.43), tolerance (45.1% versus 30.4%)(p = 0.12), and willingness to undergo a repeat colonoscopy (54.9% versus 55.4%)(p = 0.97). Conclusion: A brief educational video intervention did not improve bowel preparation in patients with IBD undergoing colonoscopy. Trial registration: CTRI/2023/09/057436 on 11 September 2023.