Sodium Phosphate Tablets vs. Polyethylene Glycol Plus Bisacodyl Tablets
Background: Patient acceptance of bowel preparation can affect colon cancer screening compliance.
Aim: To compare patient acceptance, preference and tolerability of 32-sodium phosphate tablets vs. 2L polyethylene glycol solution plus 4 bisacodyl tablets for bowel preparation.
Methods: A prospective, randomized, investigator-blinded, multicentre trial was performed. Results were based on responses to a patient questionnaire.
Results: 411 patients (205 sodium phosphate; 206 polyethylene glycol plus bisacodyl) completed the study preparation and patient questionnaire prior to colonoscopy. More patients receiving sodium phosphate vs. polyethylene glycol plus bisacodyl found it easy to take (77% vs. 42%), reported it to be without taste (47% vs. 6%), found it easy to take with respect to volume of liquid prescribed (72% vs. 27%) and indicated they would take the same preparation again in the future (96% vs. 74%, P < 0.0001 for all). Fewer patients receiving sodium phosphate vs. polyethylene glycol plus bisacodyl had to take time off work or change ordinary activities to take the study preparation (18% vs. 52%, P < 0.0001). Nausea, vomiting, bloating and abdominal pain were reported less frequently with sodium phosphate (P < 0.0013).
Conclusion: The 32-tablet sodium phosphate dosing regimen was easier to take and better tolerated, when compared to 2L polyethylene glycol plus bisacodyl tablets for bowel preparation.
Colonoscopy is a valuable tool for colon cancer screening and removal of precancerous polyps. Bowel preparation is essential for successful colonoscopy. However, bowel preparation has been identified by patients as the number one deterrent for undergoing screening colonoscopy. The fear associated with bowel preparation may be related to the taste of the preparation, volume of fluid to be taken during preparation, the purgative effect or the side effects associated with the bowel preparation. Although the purgative effect cannot be avoided, the reluctance to undergo colonoscopy can be decreased by choosing a bowel preparation that is safe, efficacious, easy to use and tolerable. This is especially important for those at high risk for colon cancer who may need to undergo colonoscopy more frequently.
Patient safety, efficacy, acceptance and tolerability of sodium phosphate (NaP) tablets have not been compared with a 2L polyethylene glycol (PEG) product. The objective of this clinical trial was to compare the colon cleansing ability, patient tolerability, patient preference and safety profile of the 32-tablet NaP dosing regimen with the 2L PEG solution plus four (20 mg total) bisacodyl tablet bowel preparation kit for adults undergoing colonoscopy. The 2L PEG solution plus bisacodyl tablets bowel preparation kit was chosen because it was the only 2L PEG product available in the US when the study was conducted and it was more likely to be accepted by patients than a 4L PEG solution. This paper summarizes the patient acceptance, preference and tolerability data from this study. The safety and efficacy data are presented in another paper.
Summary and Introduction
Summary
Background: Patient acceptance of bowel preparation can affect colon cancer screening compliance.
Aim: To compare patient acceptance, preference and tolerability of 32-sodium phosphate tablets vs. 2L polyethylene glycol solution plus 4 bisacodyl tablets for bowel preparation.
Methods: A prospective, randomized, investigator-blinded, multicentre trial was performed. Results were based on responses to a patient questionnaire.
Results: 411 patients (205 sodium phosphate; 206 polyethylene glycol plus bisacodyl) completed the study preparation and patient questionnaire prior to colonoscopy. More patients receiving sodium phosphate vs. polyethylene glycol plus bisacodyl found it easy to take (77% vs. 42%), reported it to be without taste (47% vs. 6%), found it easy to take with respect to volume of liquid prescribed (72% vs. 27%) and indicated they would take the same preparation again in the future (96% vs. 74%, P < 0.0001 for all). Fewer patients receiving sodium phosphate vs. polyethylene glycol plus bisacodyl had to take time off work or change ordinary activities to take the study preparation (18% vs. 52%, P < 0.0001). Nausea, vomiting, bloating and abdominal pain were reported less frequently with sodium phosphate (P < 0.0013).
Conclusion: The 32-tablet sodium phosphate dosing regimen was easier to take and better tolerated, when compared to 2L polyethylene glycol plus bisacodyl tablets for bowel preparation.
Introduction
Colonoscopy is a valuable tool for colon cancer screening and removal of precancerous polyps. Bowel preparation is essential for successful colonoscopy. However, bowel preparation has been identified by patients as the number one deterrent for undergoing screening colonoscopy. The fear associated with bowel preparation may be related to the taste of the preparation, volume of fluid to be taken during preparation, the purgative effect or the side effects associated with the bowel preparation. Although the purgative effect cannot be avoided, the reluctance to undergo colonoscopy can be decreased by choosing a bowel preparation that is safe, efficacious, easy to use and tolerable. This is especially important for those at high risk for colon cancer who may need to undergo colonoscopy more frequently.
Patient safety, efficacy, acceptance and tolerability of sodium phosphate (NaP) tablets have not been compared with a 2L polyethylene glycol (PEG) product. The objective of this clinical trial was to compare the colon cleansing ability, patient tolerability, patient preference and safety profile of the 32-tablet NaP dosing regimen with the 2L PEG solution plus four (20 mg total) bisacodyl tablet bowel preparation kit for adults undergoing colonoscopy. The 2L PEG solution plus bisacodyl tablets bowel preparation kit was chosen because it was the only 2L PEG product available in the US when the study was conducted and it was more likely to be accepted by patients than a 4L PEG solution. This paper summarizes the patient acceptance, preference and tolerability data from this study. The safety and efficacy data are presented in another paper.
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