Endoscopy 2020; 52(S 01): S156
DOI: 10.1055/s-0040-1704480
ESGE Days 2020 ePoster Podium presentations
Thursday, April 23, 2020 14:30 – 15:00 Safety of colonoscopy ePoster Podium 4
© Georg Thieme Verlag KG Stuttgart · New York

ASSESSMENT OF THE APPROPRIATENESS OF COLONOSCOPY IN AN OPEN ACCESS ENDOSCOPY UNIT: REFUSE OF INADEQUATE ONES AND PRIORITIZATION OF THOSE ACCEPTED

PD Redondo
Hospital Rio Hortega, Gastroenterology, Valladolid, Spain
,
HN Rodriguez
Hospital Rio Hortega, Gastroenterology, Valladolid, Spain
,
JT Tejada
Hospital Rio Hortega, Gastroenterology, Valladolid, Spain
,
EF Valenzuela
Hospital Rio Hortega, Gastroenterology, Valladolid, Spain
,
R Nájera
Hospital Rio Hortega, Gastroenterology, Valladolid, Spain
,
M Pérez-Miranda
Hospital Rio Hortega, Gastroenterology, Valladolid, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims Overuse of colonoscopy (CS) is an increasingly recognized problem.

However there are few publications describing tools to reduce the realization of CSs non-adherents with the clinical guidelines.

Objectives

  • Detect CSs referral from Primary Care (CS-PC) received in our Unit that do not meet criteria of European and Spanish Guidelines.

  • Definitely deny non-adherents request forms or temporarily those with insufficient data.

  • Detect CSs requests in individuals with alarm symptoms

  • Deny those for symptoms already studied in < 50 years old patients and CS < 3 years earlier (SS).

Estimate the repercussion of this intervention on waiting times

Methods We met with PC doctors and inserted guidelines into the intranet.

Systematic evaluation of CS-PC requests received (March 2011-December 2018). We complete data with the Electronic Clinical Record (ECR). We collected affiliation, priority, indication, FH-CRC, previous CSs.

The denied CSs were collected in the ECR and were mailed to the doctor, explaining the reason for the refusal. A contact email was provided for contact us.

Accepted requests were classified into: Preferent (P), Conventional(C) and Surveillance (S).

Patient´s written reclaims were collected.

Results 9,158 requests: 7,327 (80%) accepted (9.9% P, 38.1% C, 52% S) and 1,831 (20%) denied (1,291 definitely -14.1% of all request- and 540 temporarily).

Cause of deny: 50.1% FH-CRC, 45.4% PPS and 4.5% SS.

Rate of rejected decreased from 18.5% (2011) to 8.6% (2018).

Written claims decreased from 25% (2011) to16% (2018).

Prior to the intervention, average months delay for all CSs: 6 and after: 3 for C, 10 for S and 0.5 for P.

Conclusions 1- Review of CS-PC avoid a14.1% unnecessary CSs, mainly by FH-CRC and PPS

2- Makes sense on the waiting list, prioritizing the CSs with alarm data although surveillance ones wait more

3- Physicians and patients´ acceptance is good as long as a fluid communication is manteined.