title: CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation.
abstract: The purpose of this study was to prospectively compare participant experience and preference of limited preparation computed tomography colonography (CTC) with full-preparation colonoscopy in a consecutive series of patients at increased risk of colorectal cancer. CTC preparation comprised 180 ml diatrizoate meglumine, 80 ml barium and 30 mg bisacodyl. For the colonoscopy preparation 4 l of polyethylene glycol solution was used. Participants' experience and preference were compared using the Wilcoxon signed rank test and the chi-squared test, respectively. Associations between preference and experience parameters for the 173 participants were determined by logistic regression. Diarrhoea occurred in 94% of participants during CTC preparation. This side effect was perceived as severely or extremely burdensome by 29%. Nonetheless, the total burden was significantly lower for the CTC preparation than for colonoscopy (9% rated the CTC preparation as severely or extremely burdensome compared with 59% for colonoscopy; p < 0.001). Participants experienced significantly more pain, discomfort and total burden with the colonoscopy procedure than with CTC (p < 0.001). After 5 weeks, 69% preferred CTC, 8% were indifferent and 23% preferred colonoscopy (p < 0.001). A burdensome colonoscopy preparation and pain at colonoscopy were associated with CTC preference (p < 0.04). In conclusion, participants' experience and preference were rated in favour of CTC with limited bowel preparation compared with full-preparation colonoscopy.
authors.affiliation: Department of Radiology, University of Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands. s.jensch@amc.uva.nl
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Jensch
authors.forename: Shandra
authors.initials: S
authors.lastname: Bipat
authors.forename: Jan
authors.initials: J
authors.lastname: Peringa
authors.forename: Ayso H
authors.initials: AH
authors.lastname: de Vries
authors.forename: Anneke
authors.initials: A
authors.lastname: Heutinck
authors.forename: Evelien
authors.initials: E
authors.lastname: Dekker
authors.forename: Lubbertus C
authors.initials: LC
authors.lastname: Baak
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Montauban van Swijndregt
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
mesh_terms: D002400:Cathartics / Q000008:administration & dosage; D023881:Colonography, Computed Tomographic / Q000379:methods / Q000706:statistics & numerical data*; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D057240:Patient Preference / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
chemical_list: D002400:Cathartics