Patient preferences for bowel preparation: a discrete choice experiment.

Rationale: Colonoscopy is the preferred modality for the detection and characterization of colorectal lesions. The diagnostic accuracy and therapeutic safety of colonoscopy depends on the quality of colonic cleansing. Bowel cleansing remains a complex undertaking for patients and is often perceived as the most burdensome part of colonoscopy. Standardized bowel cleansing methods are used hospital-wide, resulting in poor bowel cleansing in 10-20% of all colonoscopy patients. Understanding patient preferences for bowel preparation enables physicians to prescribe a more preferred bowel cleansing method to reduce patient burden which may ultimately lead to better therapy adherence and better colonoscopy results. The present study aims to evaluate patient preferences for bowel preparation prior to colonoscopy by conducting a discrete choice experiment (DCE).

Objectives:

- To evaluate patient preferences for bowel preparation prior to colonoscopy.

- To identify patient subgroups with similar bowel preparation preferences.

Study design: A DCE will be conducted to elicit patients’ preferences regarding bowel preparation. After data collection, a Latent Class Analysis will be performed to identify possible subgroups present in the population.

Study population: Patients aged 18 and over who underwent an elective colonoscopy procedure, at least two weeks but no more than three months, prior to study inclusion.

Main study parameters/endpoints: Patient preferences for bowel preparation expressed in a utility function containing the relative importance for each attribute separately.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: The burden for study participants is very low. After baseline assessments patients will be asked to complete approximately 16 choice sets. These choice sets have a low burdensome nature and consist of choosing between two hypothetical methods of bowel preparation. The experiment will take patients 20 minutes, for which participants are free to choose a location (e.g., at home) and time to do so. There are no risks associated with participating in our experiment. All data will be anonymized upon completion of the questionnaire. Refusal to fill in the questionnaire or desire to withdraw from this research will not lead to any difference in treatment for the participant in question. Finally, no minors or incapacitated persons will be included in our study.

In contrast to this low burden, the rewards of the data gained is high. This study improves knowledge about patient preferences, which could help physicians to practice more personalized health care, which may ultimately lead to better therapy adherence to the bowel preparation and thus better colonoscopy results.

1x <3 months last colonoscopy

Questionnaire