The effect of a telephonic reminder on fasting duration in children undergoing computed tomography scan under sedation in a resource-limited setting – A randomized controlled trial

Abstract Background and Aims: Prolonged preprocedural fasting remains common among children undergoing diagnostic imaging, particularly in low- and middle-income country (LMIC) settings where communication challenges and high patient turnover can limit effective counseling. It can lead to increased patient discomfort, dehydration, and hypoglycemia. The aim of the study was to evaluate the effect of a telephonic reminder of fasting instructions to parents of children undergoing computed tomography (CT) scan under sedation on the proportion of children fasting for ≤6 hours. Material and Methods: A randomized controlled trial was conducted in children aged ≤13 years scheduled for a CT scan under sedation. Participants were randomized into two groups in a 1:2 (control: phone) ratio: parents in the control group received written and/or verbal fasting instructions, while those in the phone group additionally received a reminder of the same instructions via a telephonic call and text message one day before the scan. The primary outcome was the proportion of children with fasting duration ≤6 hours. The secondary outcomes included the feasibility of intervention, complications related to prolonged and inadequate fasting, and the proportion of children with delay or cancellation due to inadequate fasting. Results: A total of 161 children were included – 108 children in the phone group and 53 in the control group. The proportion of children with fasting duration ≤6 hours was higher in the phone group compared to that in the control group by both intention-to-treat analysis (primary analysis) (68.5% vs. 43.4%; P = 0.002) and as-treated analysis (79.5% vs 42.2%; P < 0.001). Delay or cancellation due to inadequate fasting was significantly more frequent in the control group (57% vs 25%; P < 0.001) Conclusions: A telephonic reminder reduced prolonged preprocedural fasting, improved periprocedural comfort, and decreased delays/cancellations in children undergoing CT scans.