Willingness to Undergo Split-Dose Bowel Preparation for Colonoscopy and Compliance with Split-Dose Instructions

Unger, Ron; Amstutz, Sable; Seo, Dong-Hoan; Huffman, Melanie; Rex, Douglas K.

doi:10.1007/s10620-009-1092-x

Cited by 58 publications

(35 citation statements)

References 22 publications

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“…It was a retrospective review of colonoscopies, andthe fact that bowel preparations were selected at the discretion of the endoscopists, resulted in uneven sample sizes among the different groups. The lack of patient satisfaction data limits our ability to assess compliance, which may have contributed to the effectiveness of each of the bowel preparations [10,17,[35][36][37] . Nevertheless, this real-world experience of bowel preps for colonoscopy in nearly 3,600 patients confirms that split dosing is superior to prior day dosing.…”

Section: Discussionmentioning

confidence: 99%

“…compliance have also been shown to be superior with SD compared to DPD preparations [10,17,18] . The aim of this study was to evaluate the effectiveness of the four most commonly used bowel preparations in our tertiary center endoscopy unit to determine whether any differences exist between the preps and whether there was a correlation between split dosing or day-prior dosing and the effectiveness of the bowel preparation in a non-study setting.…”

Section: Timing Of Colonoscopymentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Baba

Lewis

2016

Journal of Gastroenterology and Hepatology Research

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AIM: Several bowel preps are currently used for colonoscopy but only limited data are available comparing the different products. METHODS:We retrospectively reviewed all colonoscopies performed at Georgetown U. Hospital from May 2013 to May 2014. A 9-point modified Boston Bowel Preparation Scale (BBPS) was utilized (best score = 9) by experienced endoscopists. Colonoscopies without a BBPS score were excluded. seen for women vs men overall for both split-dose and day-prior dosepreps (with the exception of Moviprep ® in PD preps). Higher scores were seen for a.m. procedures but were not significant. All preps had lower scores in the right colon, regardless of being splitdose or day-prior dose. CONCLUSIONS: This real world experience in nearly 3600 patients confirms that split dosing is superior to day-prior dosing. We found women had higher BBPS scores than men but no differences were seen between morning and afternoon procedures. All preps were relatively comparable, however differences in price may be an important decision-maker. RESULTS:

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Section: Discussionmentioning

confidence: 99%

Section: Timing Of Colonoscopymentioning

confidence: 99%

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Baba

Lewis

2016

Journal of Gastroenterology and Hepatology Research

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“…Physicians often assume that their patients would not be willing to follow a recommendation of split doses [59] . Nevertheless, in a survey study in the US, when patients were explained the importance of the same-day schedule, over 85% were willing to wake up during the night to drink the second dose of a split preparation, and 78% of those who had early morning appointments actually did so [60] . There is abundant evidence indicating that bowel preparation should be administered at least in part on the same day as the examination, in relation to effectiveness of bowel cleansing and detection of neoplasms.…”

Section: A Key Factor For Optimal Preparation: Timing Of Administrationmentioning

confidence: 99%

Achieving the best bowel preparation for colonoscopy

Parra‐Blanco¹,

Ruiz²,

Álvarez-Lobos³

et al. 2014

WJG

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Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here. Core tip: Bowel preparation for colonoscopy is a central issue related to the quality of the procedure. There are different agents for bowel preparation that can be administered with different schedules. We review the most commonly used agents, as well as new agents and combinations. Moreover, certain considerations should be taken into account for special populations in order to improve safety, efficacy and tolerance. Regimens for bowel preparation in special situations are discussed, such as for pedi...

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“…Recent studies have shown that split-dosing of the bowel preparation improves the quality of colon cleansing and may also improve tolerability [2,3,4,5,6]. In the current clinical practice, split-dosing of 4 liters of PEG is adopted as a standard regimen for bowel preparation.…”

Section: Introductionmentioning

confidence: 99%

Low-Volume Morning-Only Polyethylene Glycol with Specially Designed Test Meals versus Standard-Volume Split-Dose Polyethylene Glycol with Standard Diet for Colonoscopy: A Prospective, Randomized Trial

et al. 2013

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Background/Aims: Split-dose polyethylene glycol (PEG) is a standard bowel preparation regimen for colonoscopy, but the large volume is burdensome to ingest and the night dose causes sleep disturbance. This study was performed to evaluate the efficacy and tolerability of a bowel preparation protocol using low-volume morning-only PEG with specially designed low-residue test meals (LV-PEG with TM) compared to a standard-volume split-dose PEG bowel preparation with a standard diet (SV-PEG with SD). Methods: This was a single-center, prospective, randomized, investigator-blinded, noninferiority study. The primary end point was bowel preparation quality according to the Ottawa scale. Tolerability, compliance, adverse events, sleep quality and polyp/adenoma detection were also assessed. Results: Among 197 patients analyzed (mean age 54.6 years, 51.3% men), 97 received LV-PEG with TM and 100 received SV-PEG with SD. The Ottawa score for the total colon was 3.76 ± 2.07 in the LV-PEG with TM group and 3.67 ± 1.57 in the SV-PEG with SD group (p = 0.723; difference 0.09, 95% confidence interval -0.60 to 0.42). The compliance was high (more than 95%) in both groups (p = 0.621). PEG was easier to ingest for patients in the LV-PEG with TM group compared to the SV-PEG with SD group [visual analogue scale (VAS) for difficulty: 4.64 ± 2.46 vs. 5.97 ± 2.42, respectively; p < 0.001]. Diet instructions were also easier to comply with for patients in the LV-PEG with TM group compared to the SV-PEG with SD group (VAS for difficulty: 3.11 ± 2.25 vs. 4.00 ± 2.39, respectively; p = 0.008). Patients in the LV-PEG with TM group had a lower incidence of abdominal bloating (p = 0.012) and better sleep quality (p < 0.001). There was no difference between the groups regarding polyp and adenoma detection. Conclusions: LV-PEG with TM and SV-PEG with SD have similar efficacy with regard to bowel preparation for colonoscopy. LV-PEG with TM provided easier PEG intake and diet compliance, less abdominal bloating and better sleep quality than SV-PEG with SD.

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Willingness to Undergo Split-Dose Bowel Preparation for Colonoscopy and Compliance with Split-Dose Instructions

Abstract: Acceptance of and compliance with split-dose bowel preparations is high and should not be a deterrent to prescribing split-dose preparations for colonoscopy.

Cited by 58 publications

References 22 publications

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Comparison of Four Different Colonic Preps in 3595 Patients at A University Center: A Real Life Experience

Achieving the best bowel preparation for colonoscopy

Low-Volume Morning-Only Polyethylene Glycol with Specially Designed Test Meals versus Standard-Volume Split-Dose Polyethylene Glycol with Standard Diet for Colonoscopy: A Prospective, Randomized Trial

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