Patient factors that affect quality of colonoscopy preparation

Marina Serper*, Andrew J. Gawron, Samuel G. Smith, Anjali U Pandit, Allison R. Dahlke, Elizabeth A. Bojarski, Rajesh N Keswani, Michael Wolf

*Corresponding author for this work

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Background & Aims: Optimal colonoscopy preparation requires patients to adhere to written instructions and be activated to complete the task. Among patients with chronic disease, health literacy and patient activation have been associated with outcome, but these factors have not been studied for colonoscopy. We examined the association between health literacy, patient activation, and quality of bowel preparation. Methods: We analyzed outpatient colonoscopy results from 462 adults, 55-74 years old (mean, 62 ± 6 years), who previously completed extensive neurocognitive assessments as part of a prospective study (Health Literacy and Cognitive Function in Older Adults). We collected information on cecal intubation, polyp detection, bowel preparation quality, and histopathology. Results: One-third of the patients (n= 134) had suboptimal quality of bowel preparation; 15% (n= 62) had fair quality, and 17% (n= 72) had poor quality. Limited health literacy was associated with a lower level of education (P < .001), diabetes (P < .001), and a higher number of chronic conditions (P < .001), but not quality of colonoscopy preparation. No baseline characteristics were associated with patient activation. In multivariable analysis, after adjusting for demographics and clinical characteristics, diabetes (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.14-5.25) and patient activation (OR, 2.12; 95% CI, 1.30-3.45) were independent predictors of suboptimal bowel preparation quality, but limited health literacy was not (OR, 0.76; 95% CI, 0.38-1.52). Conclusions: We investigated the relationship between health literacy, patient activation, and colonoscopy preparation quality. Lower patient activation was an independent predictor of suboptimal bowel preparation quality. Interventions to improve colonoscopy preparation quality should consider the importance of patient activation within their design.

Original languageEnglish (US)
Pages (from-to)451-457
Number of pages7
JournalClinical Gastroenterology and Hepatology
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2014

Keywords

  • Endoscopy
  • LitCog
  • Predictors
  • Procedure

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Fingerprint Dive into the research topics of 'Patient factors that affect quality of colonoscopy preparation'. Together they form a unique fingerprint.

  • Cite this