EVALUATION OF STANDARD BOWEL PREPARATION REGIMES VERSUS PLENVU (NOVEL LOW VOLUME REGIME): CLEANSE STUDY

Introduction

Poor bowel preparation is the leading cause of failed colonoscopies and increases procedure costs significantly. Poor preparation affects procedure quality and efficiency. Several 2 day regimes are currently available and recently, Plenvu, a low-volume regime that can be administered on the same day for afternoon/evening appointments has emerged. The aim of this study is to assess efficacy and tolerability of bowel preparation regimes.

Methods

In this service evaluation, patients undergoing bowel cancer screening colonoscopy at St Mark’s Hospital, London (Feb 2020-Dec 2021) were provided Plenvu (1 or 2 day regime), Moviprep (2 day regime), or Senna & Citramag (2 day regime). During the colonoscopy, the Boston Bowel Preparation Scale (BBPS) score, fluid volumes, and procedure times were recorded. In addition, patients completed a bowel preparation experience questionnaire including assessment of taste, volume acceptability, completion and side effects.

Results

There were 545 patients invited to participate with 10 exclusions (flexible sigmoidoscopies). of 535 included patients there were: 214 Moviprep 2 day, 108 Senna & Citramag 2 day, 150 Plenvu 2 days, and 63 Plenvu 1 day. BBPS scores were significantly higher in the Plenvu 1 day and 2 day regimes (p=0.01 and 0.001 respectively) compared with Senna & Citramag. BBPS score was also significantly higher in the Plenvu 2 day group compared with Moviprep (p=0.007). There were no other significant differences in BBPS score between regimes. There was no significant difference in inadequate bowel preparation rates between the groups (p=0.72). In the patient questionnaire, taste was rated to be most pleasant with Senna & Citramag which achieved statistical significance when compared with Plenvu 1 day and 2 day groups (p<0.001) and compared with Moviprep (p=0.01).

Conclusions

In this service evaluation, there was a significantly improved BBPS score for both 1 day and 2 day Plenvu regimes compared with Senna & Citramag, and an improved BBPS score for 2 day Plenvu compared with Moviprep. Plenvu may offer the potential for improved bowel preparation outcomes with the potential advantage for patients of a lower volume and same-day administration for afternoon/evening appointments.