Preassessment Interview Improves the Efficacy and Safety of Bowel Preparation for Colonoscopy

Abstract

Aim. To determine whether preassessment improves bowel preparation quality and prevents renal deterioration for chronic kidney disease (CKD) patients. Methods. Data was collected prospectively starting in January 2011 for 12 months. Patients were divided according to the presence or absence of preassessment and stratified to one of three risk groups based on patient's comorbidities and identified risk factors for poor bowel preparation; group 1 had no risk factors, group 2 had 1 risk factor, and group 3 patients had 2 or more risk factors. The association between preassessment and bowel preparation quality was analyzed using binary logistic regression. Results. 1840 colonoscopies were carried out during the period. Total number analyzed was 1704. 404 patients were preassessed. Preassessment patients had significantly better bowel preparation across all groups (OR 1.605; p = 0.002). Group 3 patients were 52% more likely to have good bowel preparation (p = 0.04) if they had been preassessed. Eighty-eight patients were identified with an eGFR < 60 mL/min. There was a significant difference in the eGFR percentage change between patients with preassessment and those without (p = 0.006). Conclusions. Face-to-face preassessment appears to improve the quality of bowel preparation and aids in minimizing the risk of renal injury in patients with CKD.

Efectividad y tolerabilidad de tres tipos de productos de preparación para colonoscopia

“…La incidencia de inadecuada preparación fue del 10 % en los pacientes evaluados, a diferencia de lo estimado en otros estudios, alrededor del 20 %-40 % (21,22) . Esta diferencia puede deberse a la educación individualizada que se ofrece a los pacientes durante la asignación de la cita y dos días previos al procedimiento (23,24) . Los pacientes con mala preparación fueron principalmente mujeres (59 %) y personas menores de 60 años (68 %), lo cual controvierte algunos factores predictores de mala preparación reportados recientemente (21,25,26) .…”