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Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation
Stacy B Menees1,2, H Myra Kim2, Grace H Elta1
1Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USA.
Gastroenterology Research and Practice
|July 31, 2018
Summary
Physician recommendations for repeat colonoscopy generally follow guidelines. However, poor bowel preparation, especially patient noncompliance with split-dose regimens, often leads to earlier repeat colonoscopies.
Area of Science:
- Gastroenterology
- Colorectal Cancer Screening
- Endoscopy
Background:
- Adherence to colorectal cancer screening guidelines for repeat colonoscopies is not well-defined.
- Factors influencing endoscopists' adherence to repeat colonoscopy recommendations are largely unknown.
Purpose of the Study:
- To prospectively evaluate physician recommendations for repeat colonoscopy in average-risk individuals undergoing screening.
- To identify patient and colonoscopy-related factors associated with guideline deviations.
Main Methods:
- Prospective cohort study of average-risk patients undergoing colonoscopy for colorectal cancer screening.
- Data collected between August 2011 and January 2013.
- Primary outcome: physician recommendations for repeat colonoscopy.
Main Results:
- 13.6% of participants received guideline-inconsistent recommendations for repeat colonoscopy.
- Suboptimal bowel preparation was the most common reason cited for earlier repeat colonoscopies.
- Patient noncompliance with split-dose bowel preparation significantly predicted guideline-inconsistent recommendations (OR=2.7).
Conclusions:
- Gastroenterologists demonstrate high adherence to colorectal cancer screening and surveillance guidelines.
- Suboptimal bowel preparation is the primary factor leading to deviations from recommended repeat colonoscopy intervals.
- Optimizing bowel preparation, particularly patient adherence to split-dose regimens, is crucial for guideline adherence.
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