Risk factors predictive of poor quality preparation during average risk colonoscopy screening

The importance of health literacy

Douglas L. Nguyen, Mark L. Wieland

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background. Inadequate colonoscopy bowel preparation can lead to increased procedural time, decreased diagnostic yield, and an increased complication rate. Little is known about which patient characteristics may predict poor bowel preparation for routine, average-risk colonoscopy evaluation. Methods: 300 consecutive patients who underwent routine, average risk outpatient screening colonoscopy during 01/01/2005 to 12/30/2008 at a primary care internal medicine clinic were retrospectively identified. Patients were between 50-80 years old and used the standard preparation of 2000ml polyethylene glycol solution (MoviPrep®). Differences in mean values between each group (inadequate vs. adequate preparation) were compared using the Student t-test. Categorical variables were compared using χ2 test. A multivariate logistical regression analysis was performed to identify characteristics predictive of poor colonoscopy preparation. Results. Of the 300 consecutive patients referred for routine outpatient colonoscopy examination, 15% had inadequate or poor colonoscopy preparation. The majority of patients with poor colonoscopy preparation (86.7%) reported either failure to complete the 2000 ml preparation or failure to follow written instructions. In the multivariate model, the four biggest clinical contributors to poor colonoscopy were an interpreter requirement, Medicaid insurance, single status, and having more than 8 active prescription medications. Conclusions. Among patients who underwent average-risk screening colonoscopy evaluation, the use of an interpreter and having Medicaid insurance were the largest predictors of inadequate colonoscopy preparation. These characteristics may be surrogate markers of lower health care literacy. Interventions to reduce poor colonoscopy preparation should be targeted at these patient populations.

Original languageEnglish (US)
Pages (from-to)369-372
Number of pages4
JournalJournal of Gastrointestinal and Liver Diseases
Volume19
Issue number4
StatePublished - Dec 2010

Fingerprint

Health Literacy
Colonoscopy
Medicaid
Outpatients
Insurance Coverage
Internal Medicine
Insurance
Prescriptions
Primary Health Care
Biomarkers
Regression Analysis

Keywords

  • Colon cancer
  • Poor preparation
  • Screening colonoscopy

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

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title = "Risk factors predictive of poor quality preparation during average risk colonoscopy screening: The importance of health literacy",
abstract = "Background. Inadequate colonoscopy bowel preparation can lead to increased procedural time, decreased diagnostic yield, and an increased complication rate. Little is known about which patient characteristics may predict poor bowel preparation for routine, average-risk colonoscopy evaluation. Methods: 300 consecutive patients who underwent routine, average risk outpatient screening colonoscopy during 01/01/2005 to 12/30/2008 at a primary care internal medicine clinic were retrospectively identified. Patients were between 50-80 years old and used the standard preparation of 2000ml polyethylene glycol solution (MoviPrep{\circledR}). Differences in mean values between each group (inadequate vs. adequate preparation) were compared using the Student t-test. Categorical variables were compared using χ2 test. A multivariate logistical regression analysis was performed to identify characteristics predictive of poor colonoscopy preparation. Results. Of the 300 consecutive patients referred for routine outpatient colonoscopy examination, 15{\%} had inadequate or poor colonoscopy preparation. The majority of patients with poor colonoscopy preparation (86.7{\%}) reported either failure to complete the 2000 ml preparation or failure to follow written instructions. In the multivariate model, the four biggest clinical contributors to poor colonoscopy were an interpreter requirement, Medicaid insurance, single status, and having more than 8 active prescription medications. Conclusions. Among patients who underwent average-risk screening colonoscopy evaluation, the use of an interpreter and having Medicaid insurance were the largest predictors of inadequate colonoscopy preparation. These characteristics may be surrogate markers of lower health care literacy. Interventions to reduce poor colonoscopy preparation should be targeted at these patient populations.",
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T1 - Risk factors predictive of poor quality preparation during average risk colonoscopy screening

T2 - The importance of health literacy

AU - Nguyen, Douglas L.

AU - Wieland, Mark L.

PY - 2010/12

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N2 - Background. Inadequate colonoscopy bowel preparation can lead to increased procedural time, decreased diagnostic yield, and an increased complication rate. Little is known about which patient characteristics may predict poor bowel preparation for routine, average-risk colonoscopy evaluation. Methods: 300 consecutive patients who underwent routine, average risk outpatient screening colonoscopy during 01/01/2005 to 12/30/2008 at a primary care internal medicine clinic were retrospectively identified. Patients were between 50-80 years old and used the standard preparation of 2000ml polyethylene glycol solution (MoviPrep®). Differences in mean values between each group (inadequate vs. adequate preparation) were compared using the Student t-test. Categorical variables were compared using χ2 test. A multivariate logistical regression analysis was performed to identify characteristics predictive of poor colonoscopy preparation. Results. Of the 300 consecutive patients referred for routine outpatient colonoscopy examination, 15% had inadequate or poor colonoscopy preparation. The majority of patients with poor colonoscopy preparation (86.7%) reported either failure to complete the 2000 ml preparation or failure to follow written instructions. In the multivariate model, the four biggest clinical contributors to poor colonoscopy were an interpreter requirement, Medicaid insurance, single status, and having more than 8 active prescription medications. Conclusions. Among patients who underwent average-risk screening colonoscopy evaluation, the use of an interpreter and having Medicaid insurance were the largest predictors of inadequate colonoscopy preparation. These characteristics may be surrogate markers of lower health care literacy. Interventions to reduce poor colonoscopy preparation should be targeted at these patient populations.

AB - Background. Inadequate colonoscopy bowel preparation can lead to increased procedural time, decreased diagnostic yield, and an increased complication rate. Little is known about which patient characteristics may predict poor bowel preparation for routine, average-risk colonoscopy evaluation. Methods: 300 consecutive patients who underwent routine, average risk outpatient screening colonoscopy during 01/01/2005 to 12/30/2008 at a primary care internal medicine clinic were retrospectively identified. Patients were between 50-80 years old and used the standard preparation of 2000ml polyethylene glycol solution (MoviPrep®). Differences in mean values between each group (inadequate vs. adequate preparation) were compared using the Student t-test. Categorical variables were compared using χ2 test. A multivariate logistical regression analysis was performed to identify characteristics predictive of poor colonoscopy preparation. Results. Of the 300 consecutive patients referred for routine outpatient colonoscopy examination, 15% had inadequate or poor colonoscopy preparation. The majority of patients with poor colonoscopy preparation (86.7%) reported either failure to complete the 2000 ml preparation or failure to follow written instructions. In the multivariate model, the four biggest clinical contributors to poor colonoscopy were an interpreter requirement, Medicaid insurance, single status, and having more than 8 active prescription medications. Conclusions. Among patients who underwent average-risk screening colonoscopy evaluation, the use of an interpreter and having Medicaid insurance were the largest predictors of inadequate colonoscopy preparation. These characteristics may be surrogate markers of lower health care literacy. Interventions to reduce poor colonoscopy preparation should be targeted at these patient populations.

KW - Colon cancer

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