Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation
Goal. To prospectively assess physician recommendations for repeat colonoscopy in an average-risk screening cohort. Background. Endoscopists’ adherence to colorectal cancer screening and surveillance guidelines for repeat colonoscopy have not been well characterized. Furthermore, little is known abo...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/8237824 |
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| _version_ | 1832560715255250944 |
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| author | Stacy B. Menees H. Myra Kim Grace H. Elta Sheryl Korsnes Philip Schoenfeld |
| author_facet | Stacy B. Menees H. Myra Kim Grace H. Elta Sheryl Korsnes Philip Schoenfeld |
| author_sort | Stacy B. Menees |
| collection | DOAJ |
| description | Goal. To prospectively assess physician recommendations for repeat colonoscopy in an average-risk screening cohort. Background. Endoscopists’ adherence to colorectal cancer screening and surveillance guidelines for repeat colonoscopy have not been well characterized. Furthermore, little is known about patient and colonoscopy factors that are associated with endoscopists’ nonadherence to guideline recommendation. Study. This is a prospective cohort of average-risk patients undergoing colonoscopy for colorectal cancer screening between August 2011 and January 2013. The primary outcome was assessment of physician recommendations for repeat colonoscopy. Results. 462 participants were prospectively enrolled. 13.6% (62) had guideline-inconsistent recommendations. 89% of the guideline-inconsistent recommendations were for an earlier interval. Endoscopists’ reports cited suboptimal bowel preparation as the most common reason for earlier repeat colonoscopy. On multivariable analysis, patient split-dose preparation noncompliance was significantly associated with guideline-inconsistent recommendation (OR = 2.7) even after adjusting for other patient or bowel preparation-related characteristics. Additionally, increased odds of guideline-inconsistent recommendation were associated with older age (>70 years old), higher BMI, having 3 or more polyps, having had at least two previous colonoscopies, suboptimal bowel preparation, and having taken at least 12 hours till clear bowel movement. Conclusions. Gastroenterologists are adherent to CRC screening and surveillance guidelines. Suboptimal bowel preparation is the most frequently cited factor in endoscopy reports leading to deviation from guidelines. Continued emphasis on optimization of bowel preparation, particularly patient compliance to split-dose regimen, is needed. |
| format | Article |
| id | doaj-art-14fb6042e0604b6fb518fe7cd4a94a3b |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-14fb6042e0604b6fb518fe7cd4a94a3b2025-02-03T01:26:46ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/82378248237824Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel PreparationStacy B. Menees0H. Myra Kim1Grace H. Elta2Sheryl Korsnes3Philip Schoenfeld4Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USADivision of Gastroenterology, Ann Arbor Veterans’ Administration Health Care System, Ann Arbor, MI, USADivision of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USADivision of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USAJohn D. Dingell VA Medical Center, Detroit, MI, USAGoal. To prospectively assess physician recommendations for repeat colonoscopy in an average-risk screening cohort. Background. Endoscopists’ adherence to colorectal cancer screening and surveillance guidelines for repeat colonoscopy have not been well characterized. Furthermore, little is known about patient and colonoscopy factors that are associated with endoscopists’ nonadherence to guideline recommendation. Study. This is a prospective cohort of average-risk patients undergoing colonoscopy for colorectal cancer screening between August 2011 and January 2013. The primary outcome was assessment of physician recommendations for repeat colonoscopy. Results. 462 participants were prospectively enrolled. 13.6% (62) had guideline-inconsistent recommendations. 89% of the guideline-inconsistent recommendations were for an earlier interval. Endoscopists’ reports cited suboptimal bowel preparation as the most common reason for earlier repeat colonoscopy. On multivariable analysis, patient split-dose preparation noncompliance was significantly associated with guideline-inconsistent recommendation (OR = 2.7) even after adjusting for other patient or bowel preparation-related characteristics. Additionally, increased odds of guideline-inconsistent recommendation were associated with older age (>70 years old), higher BMI, having 3 or more polyps, having had at least two previous colonoscopies, suboptimal bowel preparation, and having taken at least 12 hours till clear bowel movement. Conclusions. Gastroenterologists are adherent to CRC screening and surveillance guidelines. Suboptimal bowel preparation is the most frequently cited factor in endoscopy reports leading to deviation from guidelines. Continued emphasis on optimization of bowel preparation, particularly patient compliance to split-dose regimen, is needed.http://dx.doi.org/10.1155/2018/8237824 |
| spellingShingle | Stacy B. Menees H. Myra Kim Grace H. Elta Sheryl Korsnes Philip Schoenfeld Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation Gastroenterology Research and Practice |
| title | Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation |
| title_full | Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation |
| title_fullStr | Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation |
| title_full_unstemmed | Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation |
| title_short | Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation |
| title_sort | adherence to crc screening and surveillance guidelines when using split dose bowel preparation |
| url | http://dx.doi.org/10.1155/2018/8237824 |
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