Written Recommendation to Repeat Colonoscopy within 1 Year after Inadequate Bowel Preparation: A Simple and Highly...

Background and Study Aim When bowel preparation is inadequate, international guidelines recommend repeating the colonoscopy within 1 year. We aimed to evaluate the effectiveness of providing a written recommendation for improving completion of repeat colonoscopy within 1 year after inadequate bowel preparation. Materials and Methods We conducted a single-center, nonrandomized clinical trial. Consecutive outpatients' colonoscopies with inadequate bowel preparation were included. The intervention group received written recommendations concerning the necessity of repeating the colonoscopy within 1 year. Both groups were provided with verbal instructions conveying the same information. Inadequate bowel preparation was defined as a Boston Bowel Preparation Scale score of <2 points in any segment. Results In total, 464 patients with inadequate bowel preparation were included. Adherence to repeat colonoscopy within 1 year was significantly higher in the intervention group compared with the control group (54.4% vs. 29.4%; p < 0.001). On repeat colonoscopy, the adenoma detection rate was 31.5% and 1.5% of patients who were found to have colorectal cancer during this procedure. In the multivariate analysis, provision of a written recommendation was the most strongly associated factor with completion of repeat colonoscopy within 1 year (OR 3.40; 95% CI 2.22-5.26; p < 0.001). Conclusion Providing a written recommendation following inadequate bowel preparation improves completion of repeat colonoscopy within 1 year. Implementing a mandatory field in the colonoscopy report is an effective strategy to ensure patients undergo repeat colonoscopy in accordance with clinical guidelines (NCT05709145).