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CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(06): E706-E713
DOI: 10.1055/s-0044-102298
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Predictors of patient reluctance to wake early in the morning for bowel preparation for colonoscopy: a precolonoscopy survey in city-wide practice

L. A. Shafer
 1   Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
 2   Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
 3   IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada
,
J. R. Walker
 3   IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada
 4   Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
,
C. Waldman
 1   Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
 5   Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada
,
V. Michaud
 1   Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
,
C. Yang
 1   Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
,
C. N. Bernstein
 1   Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
 3   IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada
,
L. Hathout
 1   Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
,
J. Park
 6   Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
 7   CancerCare Manitoba, Department of Epidemiology and Cancer Registry, Winnipeg, Manitoba, Canada
,
J. Sisler
 7   CancerCare Manitoba, Department of Epidemiology and Cancer Registry, Winnipeg, Manitoba, Canada
 8   Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
,
K. Wittmeier
 9   Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
,
G. Restall
10   Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
,
H. Singh
 1   Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
 2   Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
 3   IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada
 7   CancerCare Manitoba, Department of Epidemiology and Cancer Registry, Winnipeg, Manitoba, Canada
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Publikationsverlauf

submitted 06. Oktober 2017

accepted after revision 22. Januar 2018

Publikationsdatum:
25. Mai 2018 (online)

Auch verfügbar auf
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Abstract

Introduction Many endoscopists do not use split-dose bowel preparation (SDBP) for morning colonoscopies. Despite SDBP being recommended practice, they believe patients will not agree to take early morning bowel preparation (BP). We assessed patients’ opinions about waking early for BP.

Methods A self-administered survey was distributed between 08/2015 and 06/2016 to patients in Winnipeg, Canada when they attended an outpatient colonoscopy. Logistic regression was performed to determine predictors of reluctance to use early morning BP.

Results Of the 1336 respondents (52 % female, median age 57 years), 33 % had used SDBP for their current colonoscopy. Of the 1336, 49 % were willing, 24 % neutral, and 27 % reluctant to do early morning BP. Predictors of reluctant versus willing were number of prior colonoscopies (OR 1.20; 95 %CI: 1.07 – 1.35), female gender (OR 1.65; 95 %CI: 1.19 – 2.29), unclear BP information (OR 1.86; 95 %CI: 1.21 – 2.85), high BP anxiety (OR 2.02; 95 %CI: 1.35 – 3.02), purpose of current colonoscopy being bowel symptoms (OR 1.40; 95 %CI: 1.00 – 1.97), use of 4 L of polyethylene glycol laxative (OR 1.45; 95 %CI: 1.02 – 2.06), not having SDBP (OR 1.96; 95 %CI: 1.31 – 2.93), and not having finished the laxative for the current colonoscopy (OR 1.66; 95 %CI: 1.01 – 2.73). Most of the same predictors were identified when reluctance was compared to willing or neutral, and in ordinal logistic regression.

Conclusions Almost three-quarters of patients do not express reluctance to get up early for BP. Among those who are reluctant, improving BP information, allaying BP-related anxiety, and use of low volume BP may increase acceptance of SDBP.

Supplemental material

 

  • References

  • 1 Rex DK. Optimal bowel preparation a practical guide for clinicians. Nat Rev Gastroenterol Hepatol 2014; 11: 419-425
    CrossrefPubMedSuche in Google Scholar
  • 2 Lebwohl B, Kastrinos F, Glick M. et al. The impact of suboptimal bowel preparation on adenoma miss rates and the factors associated with early repeat colonoscopy. Gastrointest Endosc 2011; 73: 1207-1214
    CrossrefPubMedSuche in Google Scholar
  • 3 Saltzman JR, Cash BD, Pasha SF. et al. Bowel preparation before colonoscopy. Gastrointest Endosc 2015; 81: 781-794
    CrossrefPubMedSuche in Google Scholar
  • 4 Johnson DA, Barkun AN, Cohen LB. et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Am J Gastroenterol 2014; 109: 1528
    CrossrefPubMedSuche in Google Scholar
  • 5 Nichols RL, Smith JW, Garcia RY. et al. Current practices of preoperative bowel preparation among North American colorectal surgeons. Clin Infect Dis 1997; 24: 609-619
    CrossrefPubMedSuche in Google Scholar
  • 6 Frommer D. Cleansing ability and tolerance of three bowel preparations for colonoscopy. Dis Colon Rectum 1997; 40: 100-104
    CrossrefPubMedSuche in Google Scholar
  • 7 de Leone A, Tamayo D, Fiori G. et al. Same-day 2-L PEG-citrate-simethicone plus bisacodyl vs. split 4-L PEG: Bowel cleansing for late-morning colonoscopy. World J Gastrointest Endosc 2013; 5: 433
    CrossrefPubMedSuche in Google Scholar
  • 8 Henderson JM, Barnett JL, Turgeon DK. et al. Single-day, divided-dose oral sodium phosphate laxative versus intestinal lavage as preparation for colonoscopy: efficacy and patient tolerance. Gastrointest Endosc 1995; 42: 238-243
    CrossrefPubMedSuche in Google Scholar
  • 9 Rex DK, Imperiale TF, Latinovich DR. et al. Impact of bowel preparation on efficiency and cost of colonoscopy. Am J Gastroenterol 2002; 97: 1696-1700
    CrossrefPubMedSuche in Google Scholar
  • 10 Park SS, Sinn DH, Kim Y-H. et al. Efficacy and tolerability of split-dose magnesium citrate: low-volume (2 liters) polyethylene glycol vs. single- or split-dose polyethylene glycol bowel preparation for morning colonoscopy. Am J Gastroenterol 2010; 105: 1319-1326
    CrossrefPubMedSuche in Google Scholar
  • 11 Horton N, Garber A, Hasson H. et al. Impact of single-vs. split-dose low-volume bowel preparations on bowel movement kinetics, patient inconvenience, and polyp detection: a prospective trial. Am J Gastroenterol 2016; 111: 1330-1337
    CrossrefPubMedSuche in Google Scholar
  • 12 Kilgore TW, Abdinoor AA, Szary NM. et al. Bowel preparation with split-dose polyethylene glycol before colonoscopy: a meta-analysis of randomized controlled trials. Gastrointest Endosc 2011; 73: 1240-1245
    CrossrefPubMedSuche in Google Scholar
  • 13 Enestvedt BK, Tofani C, Laine LA. et al. 4-Liter split-dose polyethylene glycol is superior to other bowel preparations, based on systematic review and meta-analysis. Clin Gastroenterol Hepatol 2012; 10: 1225-1231
    CrossrefPubMedSuche in Google Scholar
  • 14 El SayedAM, Kanafani ZA, Mourad FH. et al. A randomized single-blind trial of whole versus split-dose polyethylene glycol-electrolyte solution for colonoscopy preparation. Gastrointest Endosc 2003; 58: 36-40
    CrossrefPubMedSuche in Google Scholar
  • 15 Bucci C, Rotondano G, Hassan C. et al. Optimal bowel cleansing for colonoscopy: split the dose! A series of meta-analyses of controlled studies. Gastrointest Endosc 2014; 80: 566-576. e562
    CrossrefPubMedSuche in Google Scholar
  • 16 Cohen LB. Split dosing of bowel preparations for colonoscopy: an analysis of its efficacy, safety, and tolerability. Gastrointest Endosc 2010; 72: 406-412
    CrossrefPubMedSuche in Google Scholar
  • 17 Martel M, Barkun AN, Menard C. et al. Split-dose preparations are superior to day-before bowel cleansing regimens: a meta-analysis. Gastroenterology 2015; 149: 79-88
    CrossrefPubMedSuche in Google Scholar
  • 18 Mathus-Vliegen E, Pellisé M, Heresbach D. et al. Consensus guidelines for the use of bowel preparation prior to colonic diagnostic procedures: colonoscopy and small bowel video capsule endoscopy. Curr Med Res Opin 2013; 29: 931-945
    CrossrefPubMedSuche in Google Scholar
  • 19 Hassan C, Bretthauer M, Kaminski M. et al. Bowel preparation for colonoscopy: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 2013; 45: 142-155
    Thieme ConnectPubMedSuche in Google Scholar
  • 20 Radaelli F, Paggi S, Repici A. et al. Barriers against split-dose bowel preparation for colonoscopy. Gut 2017; 66: 1428-1433
    CrossrefPubMedSuche in Google Scholar
  • 21 Sharara AI, Mrad RRA. The modern bowel preparation in colonoscopy. Gastroenterol Clin North Am 2013; 42: 577-598
    CrossrefPubMedSuche in Google Scholar
  • 22 Unger RZ, Amstutz SP, Seo DH. et al. Willingness to undergo split-dose bowel preparation for colonoscopy and compliance with split-dose instructions. Dig Dis Sci 2010; 55: 2030-2034
    CrossrefPubMedSuche in Google Scholar
  • 23 Menees SB, Kim HM, Wren P. et al. Patient compliance and suboptimal bowel preparation with split-dose bowel regimen in average-risk screening colonoscopy. Gastrointest Endosc 2014; 79: 811-820. e813
    CrossrefPubMedSuche in Google Scholar
  • 24 Facco E, Zanette G, Favero L. et al. Toward the validation of visual analogue scale for anxiety. Anesth Prog 2011; 58: 8-13
    CrossrefPubMedSuche in Google Scholar
  • 25 Facco E, Stellini E, Bacci C. et al. Validation of visual analogue scale for anxiety (VAS-A) in preanesthesia evaluation. Minerva Anestesiol 2013; 79: 1389-1395
    PubMedSuche in Google Scholar
  • 26 Peng C-YJ, Lee KL, Ingersoll GM. An introduction to logistic regression analysis and reporting. J Educ Res 2002; 96: 3-14
    CrossrefPubMedSuche in Google Scholar
  • 27 Voiosu A, Tantau A, Garbulet C. Factors affecting colonoscopy comfort and compliance: a questionnaire based multicenter study. Rom J Intern Med 2014; 52: 151-157
    PubMedSuche in Google Scholar
  • 28 Hsueh F-C, Chen C-M, Sun C-A. et al. A study on the effects of a health education intervention on anxiety and pain during colonoscopy procedures. J Nurs Res 2016; 24: 181-189
    CrossrefPubMedSuche in Google Scholar
  • 29 Arabul M, Kandemır A, Çelık M. et al. Impact of an information video before colonoscopy on patient satisfaction and anxiety. Turk J Gastroenterol 2011; 23: 523-529
    PubMedSuche in Google Scholar
  • 30 Shaikh AA, Hussain SM, Rahn S. et al. Effect of an educational pamphlet on colon cancer screening: a randomized, prospective trial. Eur J Gastroenterol Hepatol 2010; 22: 444-449
    CrossrefPubMedSuche in Google Scholar
  • 31 Bytzer P, Lindeberg B. Impact of an information video before colonoscopy on patient satisfaction and anxiety – a randomized trial. Endoscopy 2007; 39: 710-714
    Thieme ConnectPubMedSuche in Google Scholar
  • 32 Bernstein C, Thorn M, Monsees K. et al. A prospective study of factors that determine cecal intubation time at colonoscopy. Gastrointest Endosc 2005; 61: 72-75
    CrossrefPubMedSuche in Google Scholar
  • 33 Singh H, Kaita L, Taylor G. et al. Practice and documentation of performance of colonoscopy in a central Canadian health region. Can J Gastroenterol Hepatol 2014; 28: 185-190
    CrossrefPubMedSuche in Google Scholar