Journal Article

OC68 A multicentre assessment of adequacy of bowel preparation for paediatric ileocolonoscopy using the Boston bowel preparation scale (BBPS)

Butt, A, Skoutelis, N, Mallikarjuna, A, Barraclough, H, Bremner, R, Mardare, R, Thomson, M, Kapoor, A, Narula, P, Renji, E, Hansen, R, Pigott, A, Chalmers, I, Basude, D, Gowda, R, Gillett, P, Taylor, C, Hart, J, Loganathan, S, Tierney, P

2023

Overview

Adequate bowel preparation facilitates ileocolonoscopy completion. Pediatric Endoscopy Quality Improvement Network (PEnQuIN) quality standards recommend unadjusted rates of adequate bowel preparation of ≥ 80% and terminal ileal intubation ≥85%. A Boston Bowel Preparation Scale (BBPS) score of ≥6 is adequate. This study aims to identify whether UK hospitals are attaining PEnQuIN standards, and reviews medications used.Fifteen UK hospitals participated. Local governance processes were followed. Each hospital provided anonymous BBPS data. Patients were grouped according to bowel preparation drug type. Patients were excluded if procedures were abandoned due to significant bleeding, stricture, previous resections or severe disease and if a subgroup had below 5 patients. A single factor Anova test and two sample T-Test was performed.Complete data for 209 patients from 12 hospitals was collated. Five of 12 participating hospitals attained the PEnQuIN standard for adequate bowel preparation. Bowel preparation drugs varied greatly among hospitals. Patients were grouped according to drug type for analysis(see table 1).Abstract OC68 Table 1GroupDrug/sN° PatientsPercentage achieving BBPS score of ≥6Ileal IntubationAPicosulphate & Senna10265.7%97.1%BPicosulphate6979.7%95.7%CCitramag2592%88%Only Group C achieved the desired adequate bowel preparation rate of ≥ 80%. Not all groups are equal (p<0.006) on single factor Anova analysis. Significant differences in BBPS scores between groups A&C and B&C were found on a paired T test. Significant subgroup variability exists regarding drug timing, dosage and frequency resulting in heterogeneity.This initial study highlighted marked variability in the UK use of bowel preparation medications. Only Group C attained the PEnQuIN standard for adequate bowel preparation. Groups A and B achieved high ileal intubation rates despite not meeting the standard. A large prospective multi-centred trial is required to establish the ideal medication type and protocol for bowel preparation in children.

• Publisher: BMJ Publishing Group LTD
• Subject: Intubation