{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:57:25Z","timestamp":1777892245364,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2011,6,1]],"date-time":"2011-06-01T00:00:00Z","timestamp":1306886400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Royal College of Physicians of Edinburgh"],"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:p>Introduction: Bowel preparation has led to serious adverse events. Consequently, regulatory and advisory bodies have issued guidance, including a risk stratification of patients, aiming to minimise this risk.<\/jats:p>\n                  <jats:p>Aims: To determine the impact of the new guidance on our current practice of Picolax used in colonoscopy with regard to patient stratification, compliance and service implementation.<\/jats:p>\n                  <jats:p>Methods: Patients listed for day case colonoscopy during October 2009 were audited using data from the hospital and endoscopy databases. A follow-up, structured patient telephone interview evaluated side effects, the assessment process and patient experience.<\/jats:p>\n                  <jats:p>\n                    Results: Of the participating 112 patients, 97.4% were clinically reviewed before colonoscopy, 98.3% received written instructions and 70% verbal instructions. None had their preparation dispensed by a regulated professional. Although 62% of patients were retrospectively identified as \u2018at risk\u2019 (elderly, with congestive cardiac failure, cirrhosis or chronic kidney disease or on angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, diuretics or non-steroidal anti-inflammatory drugs), none were identified before their procedure. Significant events (postural hypotension, collapse, dizziness, palpitations, faint) were seen in 4.4%, all of whom could potentially be identified as \u2018at risk\u2019 using a stratification of low estimated glomerular filtration rate\n                    <jats:sup>*<\/jats:sup>\n                    ; with relevant co-morbidity (congestive cardiac failure or cirrhosis).\n                  <\/jats:p>\n                  <jats:p>Conclusions: Given the difficulties with compliance and the high prevalence of \u2018at risk\u2019 patients, the implementation will be challenging and require significant service redesign.<\/jats:p>","DOI":"10.4997\/jrcpe.2011.202","type":"journal-article","created":{"date-parts":[[2011,6,6]],"date-time":"2011-06-06T05:51:04Z","timestamp":1307339464000},"page":"100-105","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Service implications of implementing guidance for oral bowel cleansing agents in colonoscopy"],"prefix":"10.1177","volume":"41","author":[{"given":"PK","family":"Flanagan","sequence":"first","affiliation":[{"name":"Gastroenterology Specialist Registrar, Department of Gastroenterology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MS","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Consultant Nephrologist, Department of Renal Medicine and Transplantation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SM","family":"Tin","sequence":"additional","affiliation":[{"name":"Senior Pharmacist, Pharmacy Department"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Consultant Gastroenterologist and Endoscopist, Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2011,6,1]]},"reference":[{"key":"bibr1-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(04)02776-2"},{"key":"bibr2-JRCPE.2011.202","unstructured":"2National Patient Safety Agency. Reducing risk of harm from oral bowel cleansing solutions. London: NPSA; 2009. Available from: http:\/\/www.nrls.npsa.nhs.uk\/alerts\/?entryid45=59869"},{"key":"bibr3-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03212.x"},{"key":"bibr4-JRCPE.2011.202","first-page":"1261","volume":"91","author":"Ahmed M","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"bibr5-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.09.022"},{"key":"bibr6-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i16.2010"},{"key":"bibr7-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.6.593"},{"key":"bibr8-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-005-2780-9"},{"key":"bibr9-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(96)70287-0"},{"key":"bibr10-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.7.803"},{"key":"bibr11-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005050496"},{"key":"bibr12-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03558.x"},{"key":"bibr13-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2006.03.918"},{"key":"bibr14-JRCPE.2011.202","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01047.x"},{"key":"bibr15-JRCPE.2011.202","unstructured":"15 Connor A, Tolan D, Hughes S  Consensus guidelines for the prescription and administration of oral bowel cleansing agents. London: Royal College of Radiologists; 2009. Available from: http:\/\/www.library.nhs.uk\/GuidelinesFinder\/ViewResource.aspx?resID=328025"}],"container-title":["Journal of the Royal College of Physicians of Edinburgh"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4997\/JRCPE.2011.202","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4997\/JRCPE.2011.202","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:24:28Z","timestamp":1777616668000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4997\/JRCPE.2011.202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,6]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,6]]}},"alternative-id":["10.4997\/JRCPE.2011.202"],"URL":"https:\/\/doi.org\/10.4997\/jrcpe.2011.202","relation":{},"ISSN":["1478-2715","2042-8189"],"issn-type":[{"value":"1478-2715","type":"print"},{"value":"2042-8189","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,6]]}}}