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Adherence to CRC Screening and Surveillance Guidelines when Using Split-Dose Bowel Preparation.
Menees, Stacy B; Kim, H Myra; Elta, Grace H; Korsnes, Sheryl; Schoenfeld, Philip.
Afiliação
  • Menees SB; Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USA.
  • Kim HM; Division of Gastroenterology, Ann Arbor Veterans' Administration Health Care System, Ann Arbor, MI, USA.
  • Elta GH; Division of Gastroenterology, Ann Arbor Veterans' Administration Health Care System, Ann Arbor, MI, USA.
  • Korsnes S; Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USA.
  • Schoenfeld P; Division of Gastroenterology, University of Michigan Health System, Ann Arbor, MI, USA.
Gastroenterol Res Pract ; 2018: 8237824, 2018.
Article em En | MEDLINE | ID: mdl-30057601
ABSTRACT
GOAL To prospectively assess physician recommendations for repeat colonoscopy in an average-risk screening cohort.

BACKGROUND:

Endoscopists' adherence to colorectal cancer screening and surveillance guidelines for repeat colonoscopy have not been well characterized. Furthermore, little is known about patient and colonoscopy factors that are associated with endoscopists' nonadherence to guideline recommendation. STUDY This is a prospective cohort of average-risk patients undergoing colonoscopy for colorectal cancer screening between August 2011 and January 2013. The primary outcome was assessment of physician recommendations for repeat colonoscopy.

RESULTS:

462 participants were prospectively enrolled. 13.6% (62) had guideline-inconsistent recommendations. 89% of the guideline-inconsistent recommendations were for an earlier interval. Endoscopists' reports cited suboptimal bowel preparation as the most common reason for earlier repeat colonoscopy. On multivariable analysis, patient split-dose preparation noncompliance was significantly associated with guideline-inconsistent recommendation (OR = 2.7) even after adjusting for other patient or bowel preparation-related characteristics. Additionally, increased odds of guideline-inconsistent recommendation were associated with older age (>70 years old), higher BMI, having 3 or more polyps, having had at least two previous colonoscopies, suboptimal bowel preparation, and having taken at least 12 hours till clear bowel movement.

CONCLUSIONS:

Gastroenterologists are adherent to CRC screening and surveillance guidelines. Suboptimal bowel preparation is the most frequently cited factor in endoscopy reports leading to deviation from guidelines. Continued emphasis on optimization of bowel preparation, particularly patient compliance to split-dose regimen, is needed.

Texto completo: 1 Coleções: 01-internacional Temas: Geral Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Guideline / Screening_studies Idioma: En Revista: Gastroenterol Res Pract Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Temas: Geral Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Guideline / Screening_studies Idioma: En Revista: Gastroenterol Res Pract Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos