Introduction This study involves a retrospective review of the standards of bowel preparation during screening colonoscopy at a Local Assessment Centre (LAC) in Wales. The audit data were collected over a 12-month period with an aim to identify which preparation allowed for optimum visualisation of the bowel during screening colonoscopy.
Methods The data on 224 participants who had colonoscopy performed through the Bowel Screening Wales (BSW) programme at a LAC between January 2009 and January 2010 were analysed. Inclusion criteria were that the participant must have been prescribed either Picolax or Moviprep and that they had a complete colonoscopy with examination to the Caecum. Two hundred and five participants were included, 144 participants were prescribed Picolax and 61 participants were prescribed Moviprep. Nineteen participants were excluded from the audit because they either had a limited procedure such as flexible sigmoidoscopy, or were prescribed an alternative bowel preparation. To ensure robust statistical analysis data were obtained from both Screening Colonoscopist and Specialist Screening Practitioner reports. Bowel preparation was scored according to visual appearance during the colonoscopy procedure. The categories were classified into:
Results The cost of bowel preparation based on 220 procedures a year was calculated. Picolax cost £824.00 and Moviprep cost £1336.00 a year. Therefore the additional cost to the Health Board of using Moviprep each year would appear to be £512. However, the audit identified five participants that had been prescribed Picolax who needed repeat procedures at a cost of £3690.00, while in the Moviprep group only one participant needed a repeat colonoscopy due to unsatisfactory bowel preparation at a cost of £738.00. Moviprep allowed for greater examination of the right side of the colon and could, therefore, potentially incur a higher detection rate of polyps with the improved standards of preparation.
Conclusion Moviprep proved to be statistically more effective as bowel preparation for screening colonoscopy. Of the participants prescribed Moviprep 82% had a good standard of bowel preparation, whist only 26% of participants prescribed Picolax had a good standard of bowel preparation. Following this audit Moviprep is now the first choice bowel preparation for screening colonoscopy within the Health Board, providing clinical and cost effective bowel preparation for screening participants.
Competing interests None declared.
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