Acceptance of split-dose bowel preparation regimen for colonoscopy by patients and providers

Split-dose bowel preparation (split prep) for colonoscopy has been shown to be superior to conventional dosing (entire dose taken on the evening preceding colonoscopy) and has been endorsed by recent guidelines. A potential limitation is the requirement for patients to wake up early to drink the second half.

A group of colonoscopy patients, scheduled for morning procedures were surveyed regarding their opinion about a split prep regimen. The survey specifically asked if they would be willing to wake up at 4:00 AM to drink the second half of the preparation. Primary care providers (PCPs) were given a similar survey asking for their opinion about the willingness of their patients to take a split prep regimen.

Among the 149 patients surveyed, 95 patients (64%) were willing to wake up early to complete a split prep, whereas 54 (36%) were not. The majority, 65 of 95 (68%) patients, preferred an early morning appointment. Only 3 of 95 (3%) patients preferred an afternoon one. There were no statistically significant differences between patients in favor of a split or conventional preparation, in respect to demographics, family history of colorectal cancer, or prior experience with colonoscopy. A total of 25 of 34 PCPs (74%) answered the survey. Only 14 PCPs (56%) thought their patients would be willing to wake up at 4:00 AM to complete the preparation.

Despite a high level of apprehension among PCPs, the majority of colonoscopy patients seem willing to comply with a split prep. Therefore, split prep should be used whenever possible for colonoscopy.