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 27 May 2018

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News

Barriers against split-dose bowel preparation for colonoscopy  .

A study in the latest issue of Gut assesses patients' attitude towards split regimen and patient-related factors associated with its uptake.

News image

Although split regimen is associated with higher adenoma detection and is recommended for elective colonoscopy, its adoption remains suboptimal.

The identification of patient-related barriers may improve its implementation.

Dr Radaelli and colleagues assessed patients' attitude towards split regimen and patient-related factors associated with its uptake.

In a multicenter, prospective study, outpatients undergoing colonoscopy from 8:00 to 14:00 were given written instructions for 4 L polyethylene glycol bowel preparation, offering the choice between split-dose and day-before regimens and emphasizing the superiority of split regimen on colonoscopy outcomes.

Uptake of split regimen and association with patient-related factors were explored by a 20-item questionnaire.

62% chose a split-dose regimen
Gut

Of the 1447 patients, 62% and 38% chose a split-dose and day-before regimens, respectively.

The team observed a linear correlation between time of colonoscopy appointments and split-dose uptake, from 27% in 8:00 patients to 96% in 14:00 patients.

The researchers found that colonoscopy appointment before 10:00, travel time to endoscopy service more than 1 hour, low education level, and female gender were inversely correlated with the uptake of split-dose.

Overall, the risk of travel interruption and faecal incontinence was slightly increased in split regimen patient.

The research team found that split regimen was an independent predictor of adequate colon cleansing, and polyp detection.

Dr Radaelli's team concludes, "Patient attitude towards split regimen is suboptimal, especially for early morning examinations."

"Interventions to improve patient compliance should be considered."

Gut 2017; 66:1428-1433
25 July 2017

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