Use of Drugs for Bowel Preparation for Colonoscopy in Miri General Hospital

Abstract

Introduction:

Malaysian National Cancer Registry Report 2007-2011 has reported that colorectal cancer (CRC) is the second most prevalent cancer in Malaysia after breast cancer. Early detection and removal of precancerous lesions is vital to reduce the chances of late progression of CRC which may increase the likelihoods of survival. Among the screening tools, colonoscopy remains as the current standard method for evaluating the colon. The efficacy of colonoscopy attributed by the adequacy of bowel cleansing using bowel preparation formulations. This study aims to assess the success rates of colonoscopy using the available bowel preparation formulations in Miri General Hospital and to identify the factors to ineffective bowel preparation.

Methods:

Inpatient and outpatient data extracted and collected from Pharmacy Hospital Inventory System (PHIS) from January 2017 to December 2017. Defined daily dose (DDD), cost, and rates of successful colonoscopy of each bowel preparation formulation evaluated.
Results: DDD for polyethylene glycol-electrolyte lavage solution (PEG-ELS)-based cleansing agent and sodium phosphate (NaP) solution were 0.0047 and 0.0124 respectively. The cost per bowel preparation course using PEG-ELS is 88.3% higher than NaP. Besides that, PEG-ELS showed higher rates of repeated colonoscopy compared to NaP (28.6% versus 4.6%).

Conclusion:

This study reflects the need to enforce constant appropriate counselling among patients in both settings to ensure successful colonoscopy especially patients on PEG-ELS. Comprehension of potential patient-related and procedure-related factors should aid healthcare professionals in selecting proper bowel preparation regimes accordingly, such the quality of colonoscopy performance and delivery of service to patients can be optimized.