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Gastroenterologists' Perceived Barriers to Optimal Pre-Colonoscopy Bowel Preparation: Results of a National Survey

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Abstract

Poor quality bowel preparation has been reported in almost one third of all colonoscopies. To better understand factors associated with poor bowel preparation, we explored perceived patient barriers to optimal pre-colonoscopy bowel preparation from the perspective of the gastroenterologist. A random sample of physician members of the American College of Gastroenterology was surveyed via the internet and postal mailing. Demographic and practice characteristics and practice-related and perceived patient barriers to optimal bowel preparation were assessed among 288 respondents. Lack of time, no patient education reimbursement, and volume of information were not associated with physician level of suboptimal bowel preparation. Those reporting ≥10 % suboptimal bowel preparations were more likely to believe patients lack understanding of the importance of following instructions, have problems with diet, and experience trouble tolerating the purgative. Bowel preparation instruction communication and unmet patient educational needs contribute to suboptimal bowel preparation. Educational interventions should address both practice and patient-related factors.

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Acknowledgments

This work was supported by a National Cancer Institute at the National Institutes of Health fellowship (R25 CA094601) to C.H. Basch; a National Center for Research Resources at the National Institutes of Health grant (KL2 RR024157) to B. Lebwohl; American Cancer Society (RSGT-09-012-01-CPPB) grant to C.E. Basch; and National Cancer Institute at the National Institutes of Health (K07 151769) grant to F. Kastrinos.

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Authors and Affiliations

  1. Department of Epidemiology, Mailman School of Public Health of Columbia University, 722 W. 168th Street, Room 704, New York, NY, 10032, USA

    Grace Clarke Hillyer

  2. Department of Public Health, William Paterson University, Paterson, NJ, USA

    Corey H. Basch

  3. Teachers College of Columbia University, New York, NY, USA

    Charles E. Basch

  4. Herbert Irving Comprehensive Cancer Center and Division of Digestive and Liver Diseases, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Fay Kastrinos

  5. Division of Digestive and Liver Diseases, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Benjamin Lebwohl

  6. Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, New York, NY, USA

    Benjamin Lebwohl & Beverly J. Insel

  7. Department of Epidemiology, Mailman School of Public Health of Columbia University, 722 W. 168th Street, New York, NY, 10032, USA

    Alfred I. Neugut

  8. Herbert Irving Comprehensive Cancer Center and Division of Hematology and Oncology, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Alfred I. Neugut

Authors
  1. Grace Clarke Hillyer
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  2. Corey H. Basch
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  3. Charles E. Basch
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  4. Benjamin Lebwohl
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  5. Fay Kastrinos
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  6. Beverly J. Insel
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  7. Alfred I. Neugut
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Corresponding author

Correspondence to Grace Clarke Hillyer.

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Hillyer, G.C., Basch, C.H., Basch, C.E. et al. Gastroenterologists' Perceived Barriers to Optimal Pre-Colonoscopy Bowel Preparation: Results of a National Survey. J Canc Educ 27, 526–532 (2012). https://doi.org/10.1007/s13187-012-0364-x

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  • DOI: https://doi.org/10.1007/s13187-012-0364-x

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