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; J. R. Walker; C. Waldman; V. Michaud; C. Yang; C. N. Bernstein; L. Hathout; J. Park; J. Sisler; K. Wittmeier; G. Restall; H. Singh

doi:10.1055/s-0044-102298

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(06): E706-E713
DOI: 10.1055/s-0044-102298

Original article

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

¹Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

²Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

³IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada

,

J. R. Walker

³IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada

⁴Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada

,

C. Waldman

¹Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

⁵Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada

,

V. Michaud

¹Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

,

C. Yang

¹Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

,

C. N. Bernstein

¹Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

³IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada

,

L. Hathout

¹Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

,

J. Park

⁶Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada

⁷CancerCare Manitoba, Department of Epidemiology and Cancer Registry, Winnipeg, Manitoba, Canada

,

J. Sisler

⁷CancerCare Manitoba, Department of Epidemiology and Cancer Registry, Winnipeg, Manitoba, Canada

⁸Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

,

K. Wittmeier

⁹Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada

,

G. Restall

¹⁰Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

,

H. Singh

¹Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

²Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada

³IBD Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada

⁷CancerCare Manitoba, Department of Epidemiology and Cancer Registry, Winnipeg, Manitoba, Canada

› Author Affiliations

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.

Full Text

References

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Supplementary Material

Supplementary material