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Non-medical colonoscopists are safe and effective: results from randomised controlled trial

Gardiner, A; Skinn, E; Maslekar, S; Duthie, Graeme

Authors

A Gardiner

S Maslekar

Graeme Duthie G.S.Duthie@hull.ac.uk



Abstract

Introduction: There is an increasing demand for colonoscopy, especially with introduction of screening programmes. Though it is performed by doctors and nurses, there is an acute shortage of trained colonoscopists. Non-medical personnel were therefore trained to perform colonoscopy. The aim of this study was to prospectively compare the outcome and efficacy of non-medical colonoscopists (NMC), with both medical (MEC) and nurse colonoscopists (NC). MethodsThis study was drawn from a randomised controlled trial of sedation for colonoscopy. Randomisation was stratified by endoscopist grade: MEC or NMC or NC. Patients undergoing elective colonoscopy completed anxiety questionnaires, and baseline letter cancellation test and pain score on visual analogue scale (VAS). Post-procedure all patients marked assessment of pain and satisfaction on VAS and completed letter cancellation test. Secondary outcome variables included completion rates,nurse satisfaction and rate of complications. ResultsOut of 110 patients, 40 were randomised to MEC and NC group each and 30 patients to the NMC group. Demographic characteristics of all groups were similar. Completion rate was 95%, 97.5%, and 91% in MEC, NC, and NMC groups respectively (p=0.3). There was no statistically significant difference between the groups in terms of median pain scores (p=0.1), patient satisfaction (p=0.8), nurse satisfaction (p=0.6), and time to discharge (p=0.08). No complications occurred. ConclusionThis first prospective randomised controlled trial on non-medical colonoscopy has shown that NMC is safe, feasible, and therapeutic as well as diagnostic procedures can be performed with comparable completion rates and patient satisfaction. We conclude that this is a viable and effective option that complements and reduces clinician's workload.

Journal Article Type Meeting Abstract
Publication Date Apr 30, 2006
Journal GUT
Print ISSN 0017-5749
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 55
Pages A5 - A5
APA6 Citation Gardiner, A., Skinn, E., Maslekar, S., & Duthie, G. (2006). Non-medical colonoscopists are safe and effective: results from randomised controlled trial. Gut : journal of the British Society of Gastroenterology, 55, (A5 - A5). ISSN 0017-5749
Keywords colonoscopy, non-medical, endoscopists