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Barriers against split-dose bowel preparation for colonoscopy.

F Radaelli1, S Paggi1, A Repici2

  • 1Department of Gastroenterology, Valduce Hospital, Como, Italy.

Gut
|May 20, 2016
PubMed
Summary
This summary is machine-generated.

Split-dose bowel preparation for colonoscopy improves adenoma detection but faces suboptimal patient adoption. Early morning appointments and longer travel times are key barriers to split-dose regimen uptake.

Keywords:
COLONIC POLYPSCOLONOSCOPYENDOSCOPY

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Patient Care

Background:

  • Split-dose bowel preparation is recommended for elective colonoscopy due to higher adenoma detection rates.
  • However, patient adoption of the split-dose regimen remains suboptimal, necessitating the identification of patient-related barriers.
  • Understanding patient attitudes is crucial for improving the implementation of this effective bowel preparation method.

Purpose of the Study:

  • To assess patient attitudes towards the split-dose bowel preparation regimen for colonoscopy.
  • To identify patient-related factors associated with the uptake of the split-dose regimen.
  • To evaluate the impact of appointment timing and patient demographics on split-dose regimen adherence.

Main Methods:

  • A multicentre, prospective study involving outpatients scheduled for colonoscopy.
  • Patients were offered a choice between split-dose and day-before bowel preparation (polyethylene glycol).
  • A 20-item questionnaire explored split-dose uptake and associated patient-related factors.

Main Results:

  • 61.7% of 1447 patients chose the split-dose regimen.
  • Split-dose uptake significantly increased with later colonoscopy appointment times (27.3% for 8:00 AM to 96% for 2:00 PM).
  • Factors inversely associated with split-dose uptake included early colonoscopy appointments, travel time >1 hour, low education, and female gender. Split regimen independently predicted adequate cleansing and polyp detection.

Conclusions:

  • Patient acceptance of the split-dose regimen is suboptimal, particularly for early morning colonoscopy appointments.
  • Strategies such as reorganizing colonoscopy schedules and patient educational initiatives are needed to improve compliance.
  • Addressing patient-related barriers is essential for maximizing the benefits of split-dose bowel preparation.