Danielle Goodrich MSIV University of Maryland School of Medicine Overview Colorectal Cancer Bowel Preparation Regimens Survey 2 Colorectal Cancer Third most common cancer Second leading cause of cancerrelated deaths ID: 499463
Download Presentation The PPT/PDF document "Bowel Preparation Regimens" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Bowel Preparation Regimens
Danielle Goodrich, MSIVUniversity of Maryland School of Medicine Slide2
Overview
Colorectal CancerBowel Preparation RegimensSurvey
2Slide3
Colorectal Cancer
Third most common cancerSecond leading cause of cancer-related deathsScreening colonoscopy has been shown to reduce mortality
U.S Preventive Services Task Force recommends Colorectal Cancer Screening for those aged 50 years and above with average risk
USPSTF 2009 3Slide4
Adequacy of Colonoscopy Depends on Prep
4Slide5
Adequacy of Colonoscopy
Up to 25% of patients undergoing colonoscopy have poor bowel preparationLowers the detection of small polyps (<9mm)
Increased risk of procedural complicationsDecreased completion ratesIncreases the time the endoscopist takes to try to suction and clean the colon
Van Dongen 2011
5Slide6
Liquid coming from the bowel before colonoscopy should look like….
6Slide7
Different Dosing Regimens
Split-Dose
Traditional
Same Day
Time of day
7Slide8
Split-Dose
Superior to full-dose PEG with respect toColon CleansingPatient compliance
Patient’s willingness to repeat the same bowel preparation Nausea
Kilgore et al 20118Slide9
Survey of Local CRF Programs in Maryland
13 questions aimed to identify practice habits of endoscopists involved in the programProgram managers in each county of Maryland who work directly with endoscopists through the statewide Cigarette Restitution Fund Colorectal Cancer Screening Program
9Slide10
Survey Results: Client Education
10Slide11
Survey Results: Supplier of the Preparations
11Slide12
Survey Results: Bowel Preparations
12Slide13
Survey Results: Bowel Preparations
13Slide14
Survey Results
14Slide15
Results Cont’d
15Slide16
Conclusions
Physicians are implementing split dose regimens into their practice. Physicians are using different bowel preps for different patients, suggesting they are taking into account the patients past medical history and ability to complete the various regimens.
16Slide17
Conclusion
The literature suggests that split-dose regimens:Improve quality of the studyReduce cost and complications
Are more favorable to the patient17Slide18
Information for the screening programs:
Please encourage your providers to use split-dosing regimens if not using split dose currentlyPlease disseminate our “Information to the Provider” handout to the endoscopists in your program
18Slide19
Acknowledgements
Many thanks to the program managers in the Cigarette Restitution Fund colorectal cancer screening program at the local health departments in Maryland who collected and submitted the data for this surveyMaryland DHMH Center for Cancer Prevention and Control
19Slide20
References
Monica Van Dongen. Enhancing Bowel Preparation for Colonoscopy.
Gastroenterology Nursing (2012) 35;36-44.Dwyer DM et al. Experience of a public health colorectal cancer testing program in Maryland. Public Health Reports
(2012)127:330-339.Unger RZ et al. Willingness to Undergo Split-Dose Bowel Preparation for Colonoscopy and Compliance with Split-Dose Instructions. Dig Dis
Sci (2010) 55:2030-2034.Di Palma J and Rex D. Advances in Bowel Preparations. Gastroenterology Nursing
(2011) 55:S2-S8Kilgore et al. Bowel Preparation with split-dose polyethylene glycol before colonoscopy: a meta-analysis of randomized controlled trials. Gastrointestinal Endoscopy (2011) 73:1240-1245.
Longcroft-Wheaton G and Bhandari P. Same-Day Bowel Cleansing Regimen is Superior to a Split-Dose Regimen over Two Days for Afternoon Colonoscopy.
J
Clin
Gastroenterol
(2012)46:57-61
20