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Showing content from https://pubmed.ncbi.nlm.nih.gov/28579761/ below:

Barriers and facilitators associated with colonoscopy completion in individuals with multiple chronic conditions: a qualitative study

Affiliations

• ¹ Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System.
• ² Department of Medicine, University of Minnesota, Minneapolis, MN.
• ³ Department of Medicine, University of Florida College of Medicine, Gainesville, FL.
• ⁴ Center of Innovation on Disability and Rehabilitation Research, North Florida/South Georgia Veterans Health System, Gainesville, FL.
• ⁵ Department of Medicine, Tripler Army Medical Center, Honolulu, HI.
• ⁶ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem NC.
• ⁷ Department of Community and Behavioral Health, University of Maryland, College Park, MD.
• ⁸ Geriatric Research, Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.

• PMID: 28579761
• PMCID: PMC5449171
• DOI: 10.2147/PPA.S127862

Item in Clipboard

Shahnaz Sultan et al. Patient Prefer Adherence. 2017.

• ¹ Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System.
• ² Department of Medicine, University of Minnesota, Minneapolis, MN.
• ³ Department of Medicine, University of Florida College of Medicine, Gainesville, FL.
• ⁴ Center of Innovation on Disability and Rehabilitation Research, North Florida/South Georgia Veterans Health System, Gainesville, FL.
• ⁵ Department of Medicine, Tripler Army Medical Center, Honolulu, HI.
• ⁶ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem NC.
• ⁷ Department of Community and Behavioral Health, University of Maryland, College Park, MD.
• ⁸ Geriatric Research, Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.

• PMID: 28579761
• PMCID: PMC5449171
• DOI: 10.2147/PPA.S127862

Item in Clipboard

Background: A recommendation to undergo a colonoscopy, an invasive procedure that requires commitment and motivation, planning (scheduling and finding a driver) and preparation (diet restriction and laxative consumption), may be uniquely challenging for individuals with multiple chronic conditions (MCCs). This qualitative study aimed to describe the barriers and facilitators to colonoscopy experienced by such patients.

Materials and methods: Semistructured focus groups were conducted with male Veterans who were scheduled for outpatient colonoscopy and either failed to complete the procedure or completed the examination. Focus group recordings were transcribed and analyzed by an inductive grounded approach using constant comparative analysis.

Results: Forty-four individuals aged 51-83 years participated in this study (23 adherent and 21 nonadherent). Participants had an average of 7.4 chronic conditions (range 2-14). The five most common chronic conditions were hypertension (75%), hyperlipidemia (75%), osteoarthritis/degenerative joint disease (59%), atherosclerotic heart disease (48%), and diabetes mellitus (36%). We identified four unique themes that influenced motivation to undergo a colonoscopy: competing medical priorities, low perceived benefit, a prior negative colonoscopy experience, and pre-existing medical conditions. Additionally, we identified four themes that influenced individuals' ability to complete the examination: difficulty with bowel cleansing, difficulty with travel, worry about exacerbation of pre-existing conditions, and heightened concerns about potential complications.

Conclusion: MCCs are common in individuals referred for colonoscopy and generate unique barriers to colonoscopy completion related to medication, dietary changes, transportation, preparation processes, symptoms exacerbation, and complication concerns. Future research should examine whether tailored interventions that include education and support in addressing the unique barriers can enhance colonoscopy completion.

Keywords: Veterans; adherence; colonoscopy barriers; multiple chronic conditions.

PubMed Disclaimer

Disclosure The authors report no conflicts of interest in this work.

Participant recruitment flowchart.

Participant recruitment flowchart.

Participant recruitment flowchart.

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