Enhancing bowel preparation instructions: Is the bang worth the buck,∗ or are we stuck with the muck?

MacArthur, Kristin L.; Leszczynski, Anna M.; Jacobson, Brian C.

doi:10.1016/j.gie.2016.06.039

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…In addition, our nearly 96% bowel preparation adequacy rate exceeds those reported in many studies. 28 However, we found a similar rate of adequate preparation among non-study patients at our institution undergoing colonoscopy during the same time as our study. In addition, previously published data from our institution showed similar historical rates of adequate bowel preparation.…”

Section: Discussionsupporting

confidence: 81%

The association among diet, dietary fiber, and bowel preparation at colonoscopy

Leszczynski

MacArthur

Nelson

et al. 2018

Gastrointestinal Endoscopy

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Section: Discussionsupporting

confidence: 81%

The association among diet, dietary fiber, and bowel preparation at colonoscopy

Leszczynski

MacArthur

Nelson

et al. 2018

Gastrointestinal Endoscopy

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“…Previously, it has been hypothesized that there is a "ceiling effect" of 90 % adequate bowel preparation score for educational interventions that aim to influence the scores in any endoscopy unit [28]. As a result, these interventions will be beneficial in underperforming units with scores well below the 85 % benchmark that has been advised by the US Multi-Society Task Force on Colorectal Cancer Screening [29].…”

Section: Discussionmentioning

confidence: 99%

Computer-based patient education is non-inferior to nurse counselling prior to colonoscopy: a multicenter randomized controlled trial

et al. 2020

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Background: Optimal patient education prior to colonoscopy improves adherence to instructions for bowel preparation and leads to cleaner colons. We developed computer based education (CBE) supported by video and 3D animations. We hypothesized that CBE replaces nurse counselling without losing quality of bowel preparation during colonoscopy. Methods: We conducted a prospective, multicenter, endoscopist blinded, non-inferiority randomized controlled trial. The primary outcome was adequate bowel preparation, evaluated using the Boston Bowel Preparation Scale (BBPS). Secondary outcome measures were sickness absence due to outpatient clinic visit, patient anxiety / satisfaction scores and information re-call. We included patients in four endoscopy units (rural, urban, and tertiary). Results: We screened 1035 eligible patients and randomized 845. After evaluation, 684 were included in the intention-to-treat (ITT) group. Subsequently, 497 patients were included in per-protocol (PP) analysis, 217 in nurse counselling and 280 in the CBE group. Baseline characteristics were similarly distributed among groups. In PP analysis, adequate bowel cleansing was achieved in 93.2 % (261/280) of CBE patients, which was non-inferior to nurse counselled patients (94%, 204/217), with a difference of -0.8% [95% CI [- 5.1; 3.5]%. Non-inferiority was confirmed in the ITT population. Sickness absence was significantly more frequent in nurse counselled patients (28.0% vs 4.8%). In CBE patients, 21.5% needed additional information, resulting in 3.0% extra outpatient visits. Conclusion: CBE is non-inferior to nurse counselling in terms of bowel preparation during colonoscopy, with lower patient sickness leave. CBE may serve as an efficient educational tool informing patients before colonoscopy in routine clinical practice.

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“…Table 4 lists specific evidence-based actions that can improve bowel preparation compliance 45 , and we have made an effort to implement all of these at our institution. MacArther et al have emphasized that there is no single intervention that is proven to be the most important for improving compliance, but rather practices should consider a number of different interventions that combined may be the most effective 46 .…”

Section: Methods For Improving Compliance and Outcomesmentioning

confidence: 99%

Optimal Bowel Cleansing for Colonoscopy in the Elderly Patient

Hovsepians

Gupta

2017

Drugs Aging

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Colonoscopy is an important diagnostic and screening tool for colorectal cancer detection and prevention, and adequate bowel preparation is critical for successful colonoscopy. Complications related to colonoscopy are increased in elderly patients, either directly or indirectly related to the procedure, and the risks and benefits of colonoscopy procedures need to be carefully considered in these patients. Recent studies have shown that the 4 liter polyethylene glycol with a split preparation is safe and effective for elderly patients, and is the preferred preparation for patients with medical comorbidites. Preparations containing sodium phosphate are generally not recommended for the elderly due to increased renal complications. In addition, a low residue diet may aid in tolerance and willingness to undergo the procedure compared with a clear liquid diet, with comparable bowel preparation adequacy. Risk factors for inadequate bowel preparations include poor adherence to split preparation instructions or volume of solution ingested, and certain patient related medications and comorbidities, such as diabetes, elevated body mass index, and antidepressant or narcotic use. Methods for achieving safe and adequate bowel preparations in the elderly include clear instructions, reminder calls, and case management for potential confounding patient related factors.

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Enhancing bowel preparation instructions: Is the bang worth the buck,∗ or are we stuck with the muck?

Cited by 4 publications

References 15 publications

The association among diet, dietary fiber, and bowel preparation at colonoscopy

The association among diet, dietary fiber, and bowel preparation at colonoscopy

Computer-based patient education is non-inferior to nurse counselling prior to colonoscopy: a multicenter randomized controlled trial

Optimal Bowel Cleansing for Colonoscopy in the Elderly Patient

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