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Effect of an intensive patient educational programme on the quality of bowel preparation for colonoscopy: a single-blind randomised controlled trial
  1. Sivakami Janahiraman1,
  2. Chan Yen Tay1,
  3. Jie Min Lee1,
  4. Wen Ling Lim1,
  5. Chun Hoe Khiew1,
  6. Irina Ishak2,
  7. Zakry Yahya Onn2,
  8. Mohd Razali Ibrahim2,
  9. Chun Keat Chew3
  1. 1Pharmacy, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  2. 2Surgical, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  3. 3Centre for Clinical Trial, Institute for Clinical Research, Shah Alam, Selangor Darul Ehsan, Malaysia
  1. Correspondence to Dr Sivakami Janahiraman; sivakami_5{at}


Objective Preprocedural bowel preparation is necessary for optimal colonoscopy visualisation. However, it is challenging to achieve high-quality bowel preparation among patients scheduled for colonoscopy. This study aims to evaluate the impact of an intensive patient educational programme on the quality of bowel preparation.

Design An accessor-blinded randomised controlled trial was carried out at the outpatient surgical clinic of a tertiary hospital. Patients were randomly assigned to the control group (received standard written and verbal instructions) or the experimental group (received an intensive and structured educational programme). All subjects completed a questionnaire before colonoscopy to assess their compliance, acceptability, and tolerability towards bowel preparation regime. Quality of bowel preparation was determined using the Boston Bowel Preparation Scale (BBPS).

Results A total of 300 subjects who fulfilled the inclusion criteria were recruited. The experimental group had a significantly higher proportion of good quality bowel preparation than the control group (98.7% vs 52.3%, p<0.001). The median total BBPS score was also significantly higher in the experimental group (8 vs 5, p<0.001). Factors associated with good quality of bowel preparation included educational programme (OR: 22.79, 95% CI: 4.23 to 122.85, p<0.001), compliance to bowel cleansing agent (OR: 24.98, 95% CI 3.12 to 199.71, p<0.001), very difficult acceptability of preparation (OR: 0.11, 95% CI 0.03 to 0.38, p<0.001), tolerability towards bowel preparation (OR: 4.98, 95% CI 1.44 to 17.20, p<0.011) and hypomotility drugs (OR: 3.03, 95% CI 0.12 to 0.91, p<0.05).

Conclusion An intensive patient educational programme can significantly improve the quality of bowel preparation for colonoscopy.

  • colonoscopy
  • cancer
  • colorectal cancer screening

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  • Contributors SJ conceived the research idea. SJ and CKC developed the study methodology. SJ, CYT, JML, WLL, CHK, II, ZYO, MRI and CKC planned the experiment. SJ, CYT, JML, WLL, CHK, II, ZYO and MRI carried out the study implementation and the study intervention. SJ, CYT, JML, WLL and CHK collected the study data. CKC performed the statistical analysis and interpretation. SJ, CYT, JML, WLL, CHK, CKC involve in manuscript drafting, writing and editing. All authors discussed the results and commented on the manuscript and final approval of the manuscript.

  • Funding Institute for Clinical Research (formerly known as Clinical Research Centre), National Institute of Health, Malaysia, provided funding for the study materials preparation.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data will be available if requested by any party for particular reason. Data can be obtained from the corresponding author with consent or permission.

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