title: An interview study analysing patients' experiences and perceptions of non-laxative or full-laxative preparation with faecal tagging prior to CT colonography.
abstract: OBJECTIVE
  To compare patients' experiences of either non- or full-laxative bowel preparation with additional faecal tagging and subsequent computed tomographic (CT) colonography using in-depth interviews to elicit detailed responses.
  
  
  METHODS
  Patients who received CT colonography after non- (n = 9) or full-laxative (n = 9) preparation participated in a semi-structured telephone interview at least 2 days after the investigation. Full-laxative preparation consisted of magnesium citrate and sodium picosulphate administered at home (or polyethylene glycol, if contraindicated), followed by hospital-based faecal tagging with iohexol. Non-laxative preparation was home-based barium sulphate for faecal tagging. Interviews were transcribed and thematically analysed to identify recurrent themes on patients' perceptions and experiences.
  
  
  RESULTS
  Experiences of full-laxative preparation were usually negative and characterized by pre-test diarrhoea that caused significant interference with daily routine. Post-test flatus was common. Non-laxative preparation was well-tolerated; patients reported no or minimal changes to bowel habit and rapid return to daily routine. Patients reported worry and uncertainty about the purpose of faecal tagging. For iohexol, this also added burden from waiting before testing.
  
  
  CONCLUSIONS
  Patients' responses supported previous findings that non-laxative preparation is more acceptable than full-laxative preparation but both can be improved. Faecal tagging used in combination with laxative preparation is poorly understood, adding burden and worry. Home-based non-laxative preparation is also poorly understood and patients require better information on the purpose and mechanism in order to give fully informed consent. This may also optimize adherence to instructions. Allowing home-based self-administration of all types of preparation would prevent waiting before testing.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Ghanouni
authors.forename: S G
authors.initials: SG
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Halligan
authors.forename: S A
authors.initials: SA
authors.lastname: Taylor
authors.forename: A
authors.initials: A
authors.lastname: Plumb
authors.forename: D
authors.initials: D
authors.lastname: Boone
authors.forename: C
authors.initials: C
authors.lastname: von Wagner
mesh_terms: D000368:Aged; D001294:Attitude to Health; D001466:Barium Sulfate; D002400:Cathartics / Q000008:administration & dosage; D002951:Citrates / Q000008:administration & dosage; D019343:Citric Acid / Q000008:administration & dosage; D023881:Colonography, Computed Tomographic / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging; D003287:Contrast Media; D005243:Feces; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D007472:Iohexol; D054368:Laxatives / Q000008:administration & dosage*; D008297:Male; D009942:Organometallic Compounds / Q000008:administration & dosage; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010847:Picolines / Q000008:administration & dosage; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011856:Radiographic Image Enhancement / Q000379:methods
chemical_list: D002400:Cathartics; D002951:Citrates; D003287:Contrast Media; D054368:Laxatives; D009942:Organometallic Compounds; D010847:Picolines; D001466:Barium Sulfate; D019343:Citric Acid; D011092:Polyethylene Glycols; D007472:Iohexol; C005701:picosulfate sodium; C110422:magnesium citrate