Abstract
<title>Abstract</title> <p>Objectives Coloscopy is a key method for colorectal cancer screening; however, its diagnostic accuracy is largely dependent on the quality of intestinal preparation. Currently, a significant proportion of patients exhibit inadequate intestinal preparation clinically. This not only substantially reduces the adenoma detection rate and increases the risk of missed diagnoses, but also constitutes a major bottleneck limiting the clinical efficacy of colonoscopy. Therefore, it is essential to enhance education and medication guidance regarding intestinal preparation procedures for patients undergoing colonoscopy. This study aims to compare and analyze the impact of standardized comprehensive medication guidance for bowel preparation on intestinal preparation efficacy in colonoscopy patients. Methods This study was a single-center prospective historical control study that enrolled outpatient patients undergoing colonoscopy at Zhejiang Cancer Hospital. Participants were divided into a prospective cohort (May 1, 2025 – December 30, 2025) and a historical control cohort (May 1, 2024 – December 30, 2024). Patients in the historical control cohort received routine medication instructions only, whereas those in the prospective cohort received pharmacist-led standardized comprehensive medication guidance, which included personalized medication education, scenario-based interactive feedback using visual aids, scheduled medication reminders, and post-colonoscopy questionnaire follow-ups. The primary evaluation metrics in this study were the Boston Bowel Preparation Scale (BBPS) and disease detection rate, with statistical analysis performed using SPSS 27.0. This trial is registered in medicalresearch.org.cn, MR-33-25-037470. Results A total of 1,321 outpatients undergoing colonoscopy were included, comprising 893 patients from a historical control cohort and 428 patients from a prospective cohort. There were no significant differences in baseline characteristics such as gender, age, or BMI between the two cohorts. The prospective cohort exhibited significantly higher scores in BBPS (BBPS score ≥ 7, 73.8%, P < 0.001), polyp detection rate (50.9%, P < 0.001), and cancer detection rate (2.6%, P < 0.05) compared to the retrospective cohort. Furthermore, in subgroup analyses, patients who received oral concentrated magnesium sulfate sodium potassium solution or compound polyethylene glycol electrolyte powder showed significantly higher polyp detection rates (52.8%, P < 0.001; 46.4%, P < 0.001) compared to the historical control cohort after receiving comprehensive medication guidance. Conclusion Pharmacist-led standardized in-depth medication guidance significantly improves compliance among colonoscopy patients, thereby enhancing intestinal preparation adequacy, increasing the detection rate of lesions such as polyps and carcinomas, and ultimately elevating the overall quality and diagnostic efficacy of colonoscopy examinations.</p>