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Optimal colonoscopy preparation requires patients to adhere to written instructions and be activated to complete the task. Among patients with chronic disease, health literacy and patient activation have been associated with outcome, but these factors have not been studied for colonoscopy. Dr Marina Serper and colleagues from Illinois, USA examined the association between health literacy, patient activation, and quality of bowel preparation. The research team analyzed outpatient colonoscopy results from 462 adults, 55–74 years old, who previously completed extensive neurocognitive assessments as part of a prospective study. The researchers collected information on cecal intubation, polyp detection, bowel preparation quality, and histopathology.  | | 33% of the patients had suboptimal quality of bowel preparation | | Clinical Gastroenterology & Hepatology |
The team found that about 33% of the patients had suboptimal quality of bowel preparation. The team observed that 15% had fair quality, and 17% had poor quality. Limited health literacy was associated with a lower level of education, diabetes, and a higher number of chronic conditions, but not quality of colonoscopy preparation. The researchers noted that no baseline characteristics were associated with patient activation. In multivariable analysis, after adjusting for demographics and clinical characteristics, diabetes, and patient activation were independent predictors of suboptimal bowel preparation quality, but limited health literacy was not. Dr Serper's team concludes, "We investigated the relationship between health literacy, patient activation, and colonoscopy preparation quality." "Lower patient activation was an independent predictor of suboptimal bowel preparation quality." "Interventions to improve colonoscopy preparation quality should consider the importance of patient activation within their design."
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