Effect of Counseling and Education on Mechanical Bowel Preparation

Al-Ram Drug Store150 enrolled

Overview

The goal of this clinical trial is to learn whether enhanced education and counseling can improve bowel preparation before colonoscopy in high-risk patients. The main questions it aims to answer are: Does enhanced education lead to better bowel cleansing as measured by the Boston Bowel Preparation Scale (BBPS)? Does it improve patient satisfaction, compliance with instructions, and procedure efficiency? Researchers will compare an enhanced education program (including counseling, video, booklet, and mobile app) to standard written instructions typically given before colonoscopy. Participants will: Be randomly assigned to either the enhanced education group or the standard instruction group Undergo routine colonoscopy after following the assigned preparation method Complete short questionnaires about their experience, satisfaction, and willingness to repeat the process This study is being done at two hospitals in Palestine.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

150

Conditions

Colonoscopy Colorectal Cancer Screening

Interventions

Enhanced Education Package for Bowel PreparationBEHAVIORAL

a multifaceted intervention was designed to improve mechanical bowel preparation (MBP) in patients undergoing colonoscopy. It included: Structured face-to-face counseling on the importance of bowel prep, potential complications of poor prep, and how to follow instructions. A 6-minute instructional video explaining step-by-step dietary and medication instructions. A printed booklet with visual aids summarizing key steps. A mobile phone app delivering interactive reminders, tracking tools, and preparation guidance. All participants used the same polyethylene glycol-based bowel cleansing agent.

Standard Education LeafletOTHER

Participants in this arm received a standard hospital-issued bowel preparation instruction leaflet. The document provided written instructions on dietary modifications, timing and dosage of the bowel cleansing agent, and day-of-procedure guidance. No personalized counseling, video support, or reminder tools were provided. This reflects the routine care practice at the study hospitals.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: Age 18 years or older Undergoing elective colonoscopy Considered high-risk for inadequate bowel preparation, including at least one of the following: Prior abdominal or pelvic surgery Chronic constipation (fewer than 3 bowel movements per week) Use of constipating medications (e.g., opioids, tricyclic antidepressants, calcium channel blockers) Age \>65 years Multiple comorbidities (e.g., diabetes, neurologic disorders affecting motility) \---------------------------------------------------- Exclusion Criteria: Known allergy or intolerance to bowel preparation agents Pregnancy Severe comorbidities (e.g., decompensated liver disease, severe heart failure) Cognitive impairment or illiteracy preventing understanding of instructions Emergency colonoscopy or known obstructive colorectal disease

Outcomes

Primary Outcomes

Boston Bowel Preparation Scale (BBPS) Total Score

The BBPS is a validated scoring system to assess bowel cleanliness during colonoscopy. It ranges from 0-9, with three sub-scores (right, transverse, left colon) each scored 0-3. Higher scores indicate better bowel preparation quality. Total BBPS score will be compared between groups.

Time frame: During the procedure itself

Secondary Outcomes

Patient Satisfaction Score

Measured on a 10-point Likert scale, with 1 = very dissatisfied and 10 = very satisfied. Participants were surveyed about their experience with the preparation process.

Time frame: Within 24 hours after colonoscopy

Cecal Intubation Time

Time (in minutes) from insertion of the colonoscope to successful intubation of the cecum, recorded by the performing endoscopist. Lower times indicate more efficient procedures.