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Trial registered on ANZCTR
Registration number
ACTRN12622001154796p
Ethics application status
Submitted, not yet approved
Date submitted
17/08/2022
Date registered
23/08/2022
Date last updated
23/08/2022
Date data sharing statement initially provided
23/08/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
A pilot study to compare stool softeners versus osmotic laxatives following obstetric anal sphincter injury examining defecation outcomes, wound dehicence and risk of anal incontinence
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Scientific title
A pilot study to compare stool softeners versus osmotic laxatives following obstetric anal sphincter injury examining defecation outcomes, wound dehicence and risk of anal incontinence
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Secondary ID [1]
307802
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
OASIS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obstetric anal sphincter injury
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Anal incontinence
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Wound healing
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Condition category
Condition code
Oral and Gastrointestinal
324545
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
osmotic laxatives (lactulose) 15mg twice daily oral liquid.
Medication for 2 weeks, commencing day 1 post birth on postnatal ward and continue for 2 weeks post discharge to home.
Medication compliance assessed in hospital by medication chart completion and on discharged check by continence team 2 week phone call.
Bulking fibre (Ipsaghula) is routinely given to postnatal women and will continue to be prescribed at one sachet twice daily for 2 weeks. Each sachet obtains 3.5mg of ispaghula husks mixed in one glass of water (150ml) and taken orally twice daily. Medication commenced and assessed for compliance as above for 2 week timeframe.
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Intervention code [1]
324264
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Treatment: Drugs
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Comparator / control treatment
Stool softener (Coloxyl) 200mg daily oral tablets
Medication for 2 weeks, commencing day 1 post birth on postnatal ward and continue for 2 weeks post discharge to home.
Medication compliance assessed in hospital by medication chart completion and on discharged check by continence team 2 week phone call.
Bulking fibre (Ipsaghula) is routinely given to postnatal women and will continue to be prescribed at one sachet twice daily for 2 weeks. Each sachet obtains 3.5mg of ispaghula husks mixed in one glass of water (150ml) and taken orally twice daily.Medication commenced and assessed for compliance as above for 2 week timeframe
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Control group
Active
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Outcomes
Primary outcome [1]
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Ease of evacuation - A reporting tool will assess the ease of evacuation visual analogue score . Scale from zero means no concern to 10 major concerns
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Assessment method [1]
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Timepoint [1]
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At 2 weeks post commencement of the laxative ease of evacuation will be measured.
After this timeframe when the medications are ceased ease of evacuation will be measured at 6 weeks and 12 weeks to compare evacuation
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Secondary outcome [1]
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continence status of the bowel assessed using the St Marks fecal incontinence score, and Bowel screening tool for women (BSQ) will assess anal incontinence. The Cleveland Constipation score will be used to exclude constipation
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Assessment method [1]
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Timepoint [1]
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Baseline bowel status assessed at day 1 by continence nurse team.
At 2 weeks post commencement of the laxative continence status for bowel will be measured.
After this timeframe when the medications are ceased and continence status will be measured at 6 weeks and 12 weeks to compare evacuation
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Secondary outcome [2]
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wound dehiscence will be assessed using a dichotomous scale with free text comments
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Assessment method [2]
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Timepoint [2]
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Base line data collected by continence nurse team day 1 post birth.
At 2 weeks post commencement of the laxative wound dehiscence for bowel will be measured.
After this timeframe when the medications are ceased and wound dehiscence will be measured at 6 weeks and 12 weeks to compare evacuation2 weeks
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Secondary outcome [3]
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Quality of life will be assessed using SF -12
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Assessment method [3]
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Timepoint [3]
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quality of life will be assessed at 12 week face to face appointment by the continence team.
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Eligibility
Key inclusion criteria
All women sustaining an obstetric anal sphincter injury at the study site who can provide informed consent
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
History of anal incontinence
No obstetric anal sphincter injury
History of chronic constipation
History of colorectal disease such as inflammatory bowel disease or colorectal malignancy
Allergy to study medication
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation Concealed by central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Web based randomisation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Pilot study , no formal sample size calculation
STATA SE for analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/10/2022
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Actual
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Date of last participant enrolment
Anticipated
30/09/2023
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Actual
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Date of last data collection
Anticipated
15/01/2024
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
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Lyell McEwin Hospital - Elizabeth Vale
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Recruitment postcode(s) [1]
38311
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5112 - Elizabeth Vale
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Division Surgical Specialities and Anaesthetics Northern Adelaide Local Health Network
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Address [1]
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Division of Surgical Specialties and Anesthetics Northern Adelaide Local Health Network
Lyell McEwin Hospital
Haydwon Rd
Elizabeth Vale SA 5112
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Country [1]
312072
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Australia
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Primary sponsor type
Individual
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Name
Dr Elizabeth Murphy
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Address
Divisional Director
Division of Surgical Specialties and Anesthetics Northern Adelaide Local Health Network
Lyell McEwin Hospital
Haydwon Rd
Elizabeth Vale SA 5112
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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CALHN ethics committee
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Ethics committee address [1]
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Central Adelaide Local Health Network The Queen Elizabeth Hospital Ground Floor, Basil Hetzel Institute 28 Woodville Road WOODVILLE SOUTH SA 5011
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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16/08/2022
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Approval date [1]
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Ethics approval number [1]
311480
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Summary
Brief summary
Following childbirth tears to the perineum (area between the vaginal and bowel) and vagina are common occurring in 80 to 90% of women. Tears to the anus (bottom muscle) known as 3rd or 4th degree tears and occur in 3.5% of women giving birth in Australia. To promote healing of these tears, medications are given to soften the stool (poo). Currently all women following childbirth who have sustained a tear to the bowel muscles (3rd or 4th degree tear) would have laxatives ordered. Several types of medications known as laxatives are prescribed however we do not know which one is the best. If you choose to be involved in the research, you will be allocated one of two laxatives that are prescribed for women following birth. The research team contact you and ask you about how easy it was to open your bowels (Poo), if you had any bowel incontinence (accidental loss of poo, gas or need to rush to the toilet for a Poo) or any concerns with healing of the wound (stitches). Information from this research will help guide development of a larger trial in the future. The research project aims to see how several types of laxatives affect 1. How easy or hard it was to use your bowels (Poo) after birth and until 3 months following the birth of your baby. 2. If you have accidental leakage of (Poo), called anal incontinence following birth until 3 months post birth. 3. Any concerns about healing of the stitches (3rd and 4th degree tear) following birth until 3 months post birth. ? The Continence Nursing team routinely provide follow up care to women following 3rd and 4th degree tears. As part of the research, and on discharge from hospital, you will only be required to provide verbal feedback to questions on three occasions, about how easy or difficult it was to use your bowels (do a poo) if you have accidental loss of poo (anal incontinence) and how the
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Julie Tucker
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Address
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c/o Women's and Children Division,
Family Clinic, Lyell McEwin Hospital
Northern Adelaide Local Health Network
Haydwon Rd
Elizabeth Vales SA 5112
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Country
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Australia
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Phone
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+61 435347338
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Julie Tucker
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Address
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c/o Women's and Children Division,
Family Clinic, Lyell McEwin Hospital
Northern Adelaide Local Health Network
Haydwon Rd
Elizabeth Vales SA 5112
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Country
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Australia
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Phone
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+61 435347338
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Elizabeth Murphy
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Address
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Divisional Director Division Of Surgical Specialties and Anaesthetics
Northern Adelaide Local Health Network
Lyell Mc Ewin Hospital
Haydwon Rd
Elizabeth Vales SA 5112
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Country
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Australia
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Phone
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+61 881829000
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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