BOWEL PREPARATION QUALITY: A CHALLENGE FOR EVERYONE?

Aims It´s important to know the factors affecting an adequate bowel preparation such as co-morbidities, split-dose regimens, the overall tolerability, among others. The aim of this pilot study is to evaluate if bowel preparation quality is improved after applying enhanced instructions before colonoscopy, such as nursing phone calls, delivery of leaflets about bowel preparation and clarification of doubts for patient training.

Methods This is a descriptive, quantitative and cross-sectional study. In 782 patients that underwent colonoscopy at our center, between 1^st-October and 31^st-December 2018, we assessed bowel preparation quality using the Boston Bowel Preparation Scale (BBPS). Statistical analysis was performed with t-student and chi-square methods using the SPSS software to analyze the correlation between BBPS scores and variables (sex, age, co-morbidities, bowel preparation method and procedure starting time) that may affect the quality of bowel preparation.

Results Eighty-seven percent of the patients underwent the procedure in the morning and of these 39% (N = 301) had BBPS ≤ 5. 41% of the patients had poor bowel cleansing (BBPS ≤ 5) and 3% had incomplete colonoscopies due to inadequate bowel preparation. Fourteen percent of the patients with BBPS ≤ 5 had univariable modeling factors associated with a sub-optimal bowel preparation, although with no statistically difference (p > 0.05). It was found that 91% (N = 713) used 2L PEG and did not apply the split-dose regímen. The patients of older than 50 years, 41% (N = 245) had BBPS ≤ 5.

Conclusions Despite enhanced instructions before colonoscopy, the quality of intestinal preparations was generally low. No statistical significance was observed between BBPS scores and the variables analyzed. This means that other factors and/or nursing interventions may improve the quality of bowel preparation. It is also essential to know the health literacy of populations. Patient empowerment and involvement may be a stronger contributor and will be the aim of a follow-up study.