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Medication burden, poor health literacy tied to inadequate bowel preparation

06 Oct 2019

Poor health literacy, functional status and number of daily medications are significantly associated with inadequate bowel preparation, which is a problem that accounts for the reduced yield of screening and increased healthcare cost, according to a study in a tertiary care setting.

A cross-sectional survey was performed in patients undergoing outpatient colonoscopy within the Johns Hopkins Health System to identify factors impacting the quality of bowel preparation.

Inadequate bowel preparation was defined as a Boston Bowel Preparation Score (BBPS) of <5. The strength of the association for selected factors with a BBPS <5 was assessed using Fisher’s exact, χ2 tests, and univariate and multivariate binary logistic regression.

A total of 467 patients (76.3 percent response rate) completed the survey between August 2017 and October 2017. The median BBPS was 7. Of the participants, 81.4 percent had an adequate bowel preparation (BBPS ≥5).

Factors associated with bowel preparation adequacy were as follows: level of education, health literacy, functional status, income and medication burden.

After adjusting for other factors, inadequate bowel preparation was significantly associated with poor confidence in filling forms (odds ratio [OR], 24.1; p<0.001), multiple daily prescription medications (OR, 12.49; p=0.02) and poor functional status (OR, 2.82; p=0.03).

“Inadequate bowel preparation is encountered in 17–32 percent of colonoscopies performed in the US,” the authors said. “Suboptimal colonic visualization reduces the yield of screening colonoscopies and increases healthcare costs because of longer procedure times and aborted procedures.”

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Most Read Articles
2 days ago
Chronic pancreatitis patients taking antioxidants (AO) supplementation show a sustained increase in blood levels of AO, but no additional benefit is seen on endocrine and exocrine functions, markers of fibrosis, oxidative stress (OS) and inflammation, nutritional status, pain, and quality of life (QOL) when compared with those on placebo, according to a study.
Elvira Manzano, 06 Feb 2020
Neither sleep quality nor step count had a bearing on length of hospital stay (LOS) following bowel surgery in patients with inflammatory bowel disease (IBD), according to researchers at the recent AIBD 2019 Meeting.

Stephen Padilla, 27 Jan 2020
Use of ustekinumab results in clinical remission, with successful maintenance until week 48, and improves laboratory biomarkers of disease activity in patients with moderate-to-severe Crohn’s disease (CD) who are refractory to antitumour necrosis factor (anti-TNF) therapy, according to a real-world study in Brazil presented at the 2019 Advances in Inflammatory Bowel Disease (AIBD) Annual Meeting.
Roshini Claire Anthony, 4 days ago

Children with inflammatory bowel disease (IBD) do not appear to have an elevated risk of lymphoma following treatment with anti-tumour necrosis factor (TNF) agents, according to a study presented at the recent Crohn’s and Colitis Congress 2020.