Single blind, randomised trial of efficacy and acceptability of oral Picolax versus self administered phosphate enema in bowel preparation for flexible sigmoidoscopy screening Commentary: participants should have been told they were being randomised Commentary: opportunity for patient partnership was lost
| Autor: | Roger Aubrey, Andrew Hart, Stephen Sutton, Clare Baron, Asha Senapati, Jane Wardle, Robert Edwards, Claire Cook, Jack Cuzick, J. M. A. Northover, Wendy Atkin, Peter McIntyre |
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| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Randomization medicine.diagnostic_test business.industry medicine.medical_treatment Laxative Cathartic Sigmoidoscopy General Medicine Enema digestive system digestive system diseases law.invention Surgery Clinical trial surgical procedures operative Patient satisfaction Randomized controlled trial law medicine business |
| Zdroj: | BMJ. 320:1504-1509 |
| ISSN: | 0959-8138 |
| Popis: | Objective: To compare the acceptability and efficacy of two methods of self administered bowel preparation for flexible sigmoidoscopy screening: a single phosphate enema and a single sachet of Picolax. Design: Single blind, randomised trial. Setting: Endoscopy units of two general hospitals. Participants: 1442 men and women aged 55-64 years who had agreed to be screened by flexible sigmoidoscopy. Main outcome measures: Attendance rates, compliance with allocated preparations, adverse effects, quality of bowel preparation, procedure time, and yield of neoplasia. Results: Compliance with the enema was higher than with the Picolax (608 (84%) v 566 (79%); difference 6%, 95% confidence interval 2% to 10%). Almost half of those who refused Picolax used an enema at home. Wind, incontinence, and sleep disturbance were more frequent in the Picolax group than the enema group; bottom soreness was more frequent in the enema group. Around 30% (187) found the diet restriction required by Picolax difficult; 78% (471) found the enema easy to administer. The quality of preparation was better with the enema; the proportion of procedures complete to the descending colon was greater and the mean duration of the procedure was shorter. There was no significant difference in polyp detection rates. Conclusion: A single phosphate enema self administered around one hour before leaving home is a more acceptable and effective method of preparing the distal bowel for flexible sigmoidoscopy than Picolax. |
| Databáze: | OpenAIRE |
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