Results
After the application of exclusion criteria, there were 3,560 patients in the pre-SDP group and 1,615 patients in the post-SDP group. The pre-SDP and post-SDP patient groups were similar in age, body mass index, and gender. The mean ages of patients were 62 and 61 years, respectively, in the pre-SDP and post-SDP groups. SDP use increased significantly from 9 percent to 74 percent after implementation. In comparison with the pre-SDP group, both PDRs (44.1 percent to 49.5 percent) and ADRs (26.7 percent to 31.8 percent) significantly improved in the post-SDP group. The cecal intubation rate significantly increased from 93.6 percent to 95.5 percent in the post-SDP group.
Bowel preparation quality also improved significantly in the post-SDP group. The improvement was noted mainly in patients rated with good to excellent preparations (34.9 percent to 53.9 percent), at the expense of those rated with fair to adequate preparations (54.3 percent to 37.8 percent), and to a lesser degree in those with poor to inadequate preparations (10.6 percent to 8.3 percent).
Limitations noted by the researchers included the study’s retrospective design and not all endoscopists were the same in both periods. Three endoscopists from the pre-SDP period left the institution and were replaced by five other endoscopists in the post-SDP period. The researchers concluded that system-wide implementation of split-dose preparation as the primary choice for colonoscopy significantly improved both PDRs and ADRs, overall quality of the preparation, and colonoscopy completion rates.
