Format

Send to

Choose Destination
Gastrointest Endosc. 2014 May;79(5):811-820.e3. doi: 10.1016/j.gie.2014.01.024. Epub 2014 Mar 13.

Patient compliance and suboptimal bowel preparation with split-dose bowel regimen in average-risk screening colonoscopy.

Author information

1
Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.
2
Division of Gastroenterology, Ann Arbor Veterans Administration Hospital, Ann Arbor, Michigan, USA.
3
School of Health Sciences, Oakland University, Rochester, Michigan, USA.
4
Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
5
Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA; Division of Gastroenterology, Ann Arbor Veterans Administration Hospital, Ann Arbor, Michigan, USA.

Abstract

BACKGROUND:

Although split-dose bowel regimen is recommended in colon cancer screening and surveillance guidelines, implementation in clinical practice has seemingly lagged because of concerns of patient compliance.

OBJECTIVES:

To assess patient compliance with the split-dose bowel regimen and assess patient- and preparation process-related factors associated with compliance and bowel preparation adequacy.

DESIGN:

Prospective survey cohort.

SETTING:

Tertiary care setting.

PATIENTS:

Average-risk patients undergoing colonoscopy for colorectal cancer screening between August 2011 and January 2013.

MAIN OUTCOME MEASUREMENTS:

Split-dose bowel regimen patient-reported compliance and bowel preparation adequacy with the Boston Bowel Preparation Scale score.

RESULTS:

Surveys and Boston Bowel Preparation Scale score data were completed in 462 participants; 15.4% were noncompliant with the split-dose bowel regimen, and suboptimal bowel preparation (score <5) was reported in 16% of all procedures. White (P = .009) and married (P = .01) subjects were least likely to be noncompliant, whereas Hispanic subjects and those who reported incomes of US$75,000 or less were most likely to be noncompliant (P = .004). Participants who were noncompliant with split-dosing were less likely to follow the other laxative instructions and more likely to have their colonoscopy appointment before 10:30 am. Compliance differed by bowel preparation type (P = .003, χ(2) test), with those who used MiraLAX showing the highest compliance, followed by polyethylene glycol electrolyte solution and other bowel preparations. Noncompliance with split-dose bowel preparation (odds ratio 6.7; 95% confidence interval, 3.2-14.2) was the strongest predictor of suboptimal bowel preparation.

LIMITATIONS:

Patient self-report, performed at tertiary care center.

CONCLUSIONS:

Overall, 1 in 7 patients do not comply with a split-dose bowel regimen. Ensuring compliance with the split-dose bowel regimen will reduce the risk of a suboptimal bowel preparation.

PMID:
24631492
PMCID:
PMC4107415
DOI:
10.1016/j.gie.2014.01.024
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center