Optimizing Adequacy of Bowel Cleansing for Colonoscopy
Optimizing Adequacy of Bowel Cleansing for Colonoscopy
Recommendations
A patient education program administered by health care professionals increases patient compliance, improves quality, and decreases repeat examinations and costs The use of both verbal and written instructions, compared with written instructions only, is an independent predictor of adequate bowel preparation quality. Educational tools such as booklets, information leaflets, animations, and visual aids should be standardized and validated, and should be effective across a range of health literacy and education levels The use of a novel patient educational booklet on precolonoscopy preparation resulted in better bowel preparation quality scores than those achieved using conventional instructions (OR, 3.7; 95% CI, 2.3–5.8)
Trained patient navigators help guide patients through the colonoscopy process. They provide education to patients, address barriers to colonoscopy, review bowel preparation protocols and appointments, and ensure that patients have an escort for appointments. Patient navigators for urban minorities in open-access referral systems resulted in an increase for screening colonoscopy completion rates. In safety-net hospitals the costs of navigation are offset by increased screening compliance and navigation is cost effective Barriers to successful navigation included incomplete contact information, language problems, and insurance lapses. The impact of the sex, ethnicity, and professional status of the patient navigator needs additional evaluation.
Usefulness of Patient Education and Navigators for Optimizing Preparation Results
Recommendations
Health care professionals should provide both oral and written patient education instructions for all components of the colonoscopy preparation and emphasize the importance of compliance ( Strong recommendation, moderate-quality evidence ).
The physician performing the colonoscopy should ensure that appropriate support and process measures are in place for patients to achieve adequate colonoscopy preparation quality ( Strong recommendation, low-quality evidence ).
A patient education program administered by health care professionals increases patient compliance, improves quality, and decreases repeat examinations and costs The use of both verbal and written instructions, compared with written instructions only, is an independent predictor of adequate bowel preparation quality. Educational tools such as booklets, information leaflets, animations, and visual aids should be standardized and validated, and should be effective across a range of health literacy and education levels The use of a novel patient educational booklet on precolonoscopy preparation resulted in better bowel preparation quality scores than those achieved using conventional instructions (OR, 3.7; 95% CI, 2.3–5.8)
Trained patient navigators help guide patients through the colonoscopy process. They provide education to patients, address barriers to colonoscopy, review bowel preparation protocols and appointments, and ensure that patients have an escort for appointments. Patient navigators for urban minorities in open-access referral systems resulted in an increase for screening colonoscopy completion rates. In safety-net hospitals the costs of navigation are offset by increased screening compliance and navigation is cost effective Barriers to successful navigation included incomplete contact information, language problems, and insurance lapses. The impact of the sex, ethnicity, and professional status of the patient navigator needs additional evaluation.
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