Patient Tolerability of Bowel Preparation is Associated with Polyp Detection Rate During Colonoscopy

Holt, Edward W.; Yimam, Kidist; Ma, Hanley; Shaw, Richard E.; Sundberg, Richard; Verhille, Michael S.

doi:10.15403/jgld.2014.1121.232.ewh1

Cited by 18 publications

(14 citation statements)

References 21 publications

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“…Male patients were more likely to report a tolerable bowel preparation experience than female patients, consistently with previously published literature [ 29 , 30 ]. These earlier studies are unlikely to represent the diverse patient population included in this study, further suggesting that sex is an independent risk factor for bowel preparation tolerability.…”

Section: Discussionsupporting

confidence: 87%

Split- versus single-dose preparation tolerability in a multiethnic population: decreased side effects but greater social barriers

Perreault

Goodman

Larion

et al. 2018

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Background:This study was performed to compare patient-reported tolerability and its barriers in single- vs. split-dose 4-L polyethylene glycol (PEG) bowel preparation for colonoscopy in a large multiethnic, safety-net patient population.Methods:A cross-sectional, dual-center study using a multi-language survey was used to collect patient-reported demographic, medical, socioeconomic, and tolerability data from patients undergoing outpatient colonoscopy. Univariate and multivariate analyses were used to identify demographic and clinical factors significantly associated with patient-reported bowel preparation tolerability.Results:A total of 1023 complete surveys were included, of which 342 (33.4%) completed single-dose and 681 (66.6%) split-dose bowel preparation. Thirty-nine percent of the patients were Hispanic, 50% had Medicaid or no insurance, and 34% had limited English proficiency. Patients who underwent split-dose preparation were significantly more likely to report a tolerable preparation, with less severe symptoms, than were patients who underwent single-dose preparation. Multiple logistic regression revealed that male sex and instructions in the preferred language were associated with tolerability of the single-dose preparation, while male sex and concerns about medications were associated with tolerability of the split-dose preparation.Conclusions:In a large multiethnic safety-net population, split-dose bowel preparation was significantly more tolerable and associated with less severe gastrointestinal symptoms than single-dose preparation. The tolerability of split-dose bowel preparation was associated with social barriers, including concerns about interfering with other medications.

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Section: Discussionsupporting

confidence: 87%

Split- versus single-dose preparation tolerability in a multiethnic population: decreased side effects but greater social barriers

Perreault

Goodman

Larion

et al. 2018

aog

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“…This difference was not explained by other factors, including age, country, indication for colonoscopy or rapidity of intake of the preparation. Worse tolerability of colonoscopy preparations in females than in males has been reported in previous studies involving OSS [25] and other bowel preparations [26].…”

Section: Discussionsupporting

confidence: 52%

A European, multicentre, observational, post-authorisation safety study of oral sulphate solution: compliance and safety

et al. 2020

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Background and study aims Oral sulphate solution (OSS) is a sulphate-based, low-volume bowel cleansing preparation taken in two doses of 500 mL, each followed by 1000mL of water or clear liquid. The primary objective of this observational study was to document compliance with the recommended hydration guidelines in a representative sample of the European population. Patients and methods Prospective, non-interventional, multicentre study (NCT02630680, EUPAS9361) in patients prescribed OSS for colonoscopy preparation in routine clinical practice in Europe. Patients were included according to pre-agreed consecutive enrolment rules. Patients recorded the volume of OSS and water or clear liquid intake, and occurrence of adverse events (AEs). Compliance with hydration was calculated as a ratio of actual volume of water/clear liquid taken versus prescribed 2,000 mL, and non-compliance defined as < 75 % intake. Colon cleansing level was assessed on a 4-point scale. Results Between October 2015 and January 2017, 1,281 patients were recruited in 16 centres in four European countries (safety population n = 1,206; registry population n = 1,177). Of patients, 94.5 % were ≥ 75 % and 86.8 % 100 % compliant with hydration guidelines. Patients took an average of 96.8 % of the recommended OSS volume; 46 patients (3.9 %) were non-compliant. Colon cleansing levels were good-to-excellent in 87.6 % of patients. Three hundred and twenty-nine patients (27.3 %) experienced 758 treatment-related AEs, mostly gastrointestinal (82.9 %), all were mild-to-moderate. Non-compliant patients had no AEs suggestive of dehydration. Conclusion In this non-interventional study in a real-life setting, treatment compliance with hydration guidelines was good-to-excellent in 94.5 % of patients receiving OSS. The safety profile of OSS was similar to the prescribing information. TRIAL REGISTRATION: Observational study EUPAS9361 at www.encepp.eu

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“…BBPS was converted to the Aronchick scale using data from Lai et al [ 18 ]. Only one publication used the Ottawa scale and due to limited data only conversion to the broad categories optimal/ suboptimal was possible [ 19 ]. No study used the Chicago scale.…”

Section: Methodsmentioning

confidence: 99%

Meta-Analysis of the Effect of Bowel Preparation on Adenoma Detection: Early Adenomas Affected Stronger than Advanced Adenomas

et al. 2016

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Background and AimsLow-quality bowel preparation reduces efficacy of colonoscopy. We aimed to summarize effects of bowel preparation on detection of adenomas, advanced adenomas and colorectal cancer.MethodsA systematic literature search was performed regarding detection of colonic lesions after normal and low-quality bowel preparation. Reported bowel preparation quality was transformed to the Aronchick scale with its qualities “excellent”, “good”, “fair”, “poor”, and “insufficient” or “optimal” (good/excellent), “suboptimal” (fair/poor/insufficient), “adequate” (good/excellent/fair) and “inadequate” (poor/insufficient). We identified two types of studies: i) Comparative studies, directly comparing lesion detection according to bowel preparation quality, and ii) repeat colonoscopy studies, reporting results of a second colonoscopy after previous low-quality preparation.ResultsThe detection of early adenomas was reduced with inadequate vs. adequate bowel preparation (Odds Ratio (OR) 0.53, CI: 0.46–0.62, p<0.001). The advanced adenomas were affected less in comparison (0.74, CI: 0.62–0.87, p<0.001). The large number of subjects considered in the present meta-analysis resulted in smaller confidence intervals compared to earlier studies. Classifying the bowel-preparation quality as suboptimal vs. optimal led to the same qualitative conclusion (OR: 0.81, CI: 0.74–0.89, p<0.001 for early adenomas, OR: 0.94, CI: 0.87–1.01, n.s. for advanced adenomas). Bowel preparation was equally important for right-sided/ flat/ serrated vs. other lesions in most observational studies but more relevant in some repeat colonoscopy studies; data regarding carcinoma detection were insufficient.ConclusionInadequate bowel preparation affects detection of early colonic lesions stronger than advanced lesions.

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Patient Tolerability of Bowel Preparation is Associated with Polyp Detection Rate During Colonoscopy

Cited by 18 publications

References 21 publications

Split- versus single-dose preparation tolerability in a multiethnic population: decreased side effects but greater social barriers

Split- versus single-dose preparation tolerability in a multiethnic population: decreased side effects but greater social barriers

A European, multicentre, observational, post-authorisation safety study of oral sulphate solution: compliance and safety

Meta-Analysis of the Effect of Bowel Preparation on Adenoma Detection: Early Adenomas Affected Stronger than Advanced Adenomas

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