Face-to-Face Instruction and Personalized Regimens Improve the Quality of Inpatient Bowel Preparation for Colonoscopy

Gao, Huizhi; Liu, Cenqin; Yuan, Xin; Lu, Hongpeng; Xia, Yonghong; Zhang, Zhixin; Bao, Zhenfei; Wang, Weihong; Xie, Jiarong; Xu, Lei

doi:10.1007/s10620-021-07290-x

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…Second, it has demonstrated that patient-related factors like drugs intake, previous abdominal surgery, and chronic constipation may be associated with an increased risk of inadequate preparation; nevertheless, we did not enroll these factors, which may influence the accuracy of the results (26)(27)(28)(29). Third, past research showed that poor patient compliance may also cause inadequate bowel preparation (30). Educating and motivating patients to improve compliance could obtain better bowel cleansing; however, our study did not evaluate such aspect.…”

Section: Discussionmentioning

confidence: 80%

Optimizing bowel preparation for colonoscopy: A cross-sectional study of the Chinese population

Liu

Zhang

et al. 2022

Front. Public Health

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BackgroundThe quality of bowel preparation is an important factor in the success of colonoscopy. However, the quality of bowel preparation is often affected by multiple factors. The main objective of this study was to explore the specific factors that affect the quality of bowel preparation.MethodsPatients were consecutively recruited from the gastroenterology department in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan from May 2018 to December 2018. All patients were undergoing colonoscopy. Bowel preparation was evaluated by the Ottawa Bowel preparation Scale (OBPS) and all patients were categorized into 2 groups according to the OBPS. Multivariate analysis was conducted to identify the factors associated with bowel preparation quality.ResultsA total of 910 patients were included in the analysis with an average age of 48.62 ± 13.57 years. Patient source (P < 0.001) and the preparation method (P = 0.029) were correlated with OBPS adequacy. In addition, after stratified by age, preparation method (P = 0.022) was a significant factor among patients under 50 years old; whereas waiting time (P = 0.005) was a significant factor among patients over 50 years old.ConclusionBowel preparation should be tailored based on the age of the patients to determine the most appropriate plan, including the most appropriate waiting time and the most appropriate purgative combination. Doctors should also focus more on the quality of bowel preparation in inpatients, who are more likely than outpatients to have an inadequate bowel preparation.

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Section: Discussionmentioning

confidence: 80%

Optimizing bowel preparation for colonoscopy: A cross-sectional study of the Chinese population

Liu

Zhang

et al. 2022

Front. Public Health

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“…[7,8] In addition, inpatients are often considered to be "hard-to-prepare," [9] which may be related to the fact that inpatients have more severe disease than outpatients. [10] Therefore, researchers have recently been investigating ways to improve bowel cleansing in inpatients, such as face-to-face instruction for patients with risk factors for inadequate bowel preparation [11] or changes in the dose of medications taken. To date, polyethylene glycol (PEG) solutions have become the most common protocol before colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

2L polyethylene glycol combined with castor oil versus 4L polyethylene glycol for bowel preparation before colonoscopy among inpatients

et al. 2023

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Inpatients are more likely to have inadequate bowel preparation compared to outpatients. Although experts recommend 4L split polyethylene glycol (PEG) preparation, bowel preparation with castor oil (CaO) was recently found to reduce the volume of solution required. The aim of the study was to evaluate the cleansing effect and safety of 2L-PEG with Cao in bowel preparation among inpatients. Our study retrospectively analyzed the medical records and colonoscopy reports of inpatients (n = 1251) who underwent colonoscopy in the Affiliated Changzhou No.2 People Hospital of Nanjing Medical University, and the inpatients were divided into 2L-PEG-CaO and 4L-PEG group according to different bowel preparation protocols. Boston Bowel Preparation Scale (BBPS) is used to assess bowel preparation efficacy before colonoscopy. Furthermore, we also calculated other outcomes, such as polyp or adenoma detection rates and adverse events. A total of 1251 patients undergoing colonoscopy were included in this study, 738 were taken 4L-PEG and 513 2L-PEG-CaO. Both inpatients groups were matched for baseline characteristics. The 2L-PEG-CaO group was significantly higher than the 4L-PEG group on both BBPS (7.26 ± 1.75 vs 7.06 ± 1.58, P = .043) and adequate bowel cleansing rates (83.2% vs 77.4%, P = .011). Regarding adverse events, the 4L-PEG group was significantly higher than the 2L-PEG-CaO group on the incidence of abdominal fullness (6.4% vs 9.6%, P = .045) and adverse events (33.7% vs 28.5%, P = .048). The 2L split PEG with CaO preparation increased quality of bowel cleansing and improved tolerance in inpatients. Bowel preparation with 2L-PEG-CaO is suitable alternative to traditional 4L split PEG bowel preparation for colonoscopy of inpatients.

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“…Inpatient status has been identi ed as a well-known risk factor for inadequate colon cleansing, and in fact about 50-70% of inpatients achieving a competent colon cleansing, which is still a long way from our imagined threshold of 90% [7,8]. In addition, inpatients are often considered to be "hard-to-prepare" [9], so many researchers have recently investigated ways to improve bowel cleansing in inpatients, such as face-to-face instruction for patients with risk factors for inadequate bowel preparation [10]. To date, polyethylene glycol (PEG) solutions have become the most common protocol prior to colonoscopy [11].…”

Section: Introductionmentioning

confidence: 99%

2L polyethylene glycol combined with castor oil versus 4L polyethylene glycol for bowel preparation before colonoscopy among inpatients

Xiong

Fang

Feng

et al. 2022

Preprint

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Objectives: The study aimed to compare the cleansing effect, compliance and adverse of polyethylene glycol 2L with castor oil and polyethylene glycol 4L on bowel preparation prior to colonoscopy in inpatients.Methods: Our study retrospectively analyzed the medical records and colonoscopy reports of inpatients (n=673) who underwent colonoscopy at the Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, and the inpatients were divided into two groups according to different bowel preparation protocols. BBPS is used to assess the degree of bowel cleanliness before colonoscopy. We statistically analyzed and compared the degree of bowel cleansing between 2L-PEG-CaO and 4L-PEG group, as well as the compliance and adverse effects of the medication in both groups.Results: Among 673 patients undergoing colonoscopy, 330 were prescribed 4L-PEG and 343 2L-PEG-CAO. Both groups of inpatients were matched for baseline characteristics. In the 4L-PEG and 2L-PEG-CaO groups, adequate bowel preparation rate was 72.4% and 77.3% (P=0.148), BBPS scores was 6.79±1.51 and 7.03±1.71 (P=0.056), and adverse event rate was 68.2% and 30.0% (P<0.001), respectively.Conclusion: The 2L-PEG combined with castor oil is an effective and safe cleansing regimen for bowel preparation and is relatively inexpensive and suitable for wider use.

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Face-to-Face Instruction and Personalized Regimens Improve the Quality of Inpatient Bowel Preparation for Colonoscopy

Cited by 5 publications

References 37 publications

Optimizing bowel preparation for colonoscopy: A cross-sectional study of the Chinese population

Optimizing bowel preparation for colonoscopy: A cross-sectional study of the Chinese population

2L polyethylene glycol combined with castor oil versus 4L polyethylene glycol for bowel preparation before colonoscopy among inpatients

2L polyethylene glycol combined with castor oil versus 4L polyethylene glycol for bowel preparation before colonoscopy among inpatients

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