OC-062A Multi-centre Pragmatic Study Of An Educational Intervention To Improve Adenoma Detection At Colonoscopy

IntroductionHigh quality colonoscopy prevents colorectal cancers. Low adenoma detection rates (ADR) are linked to subsequent high interval cancer rates. Variability in ADR exists between practitioners. Withdrawal time of >6 min, Buscopan use, position change and rectal retroflexion have some evidence to improve lesion detection. Implementation of evidence based 'bundles' of care has shown to be effective in improving outcomes in other clincal settings [1].MethodsWe aimed to evaluate the feasibility of implementing a 'bundle' comprising the above measures into routine practice and effect on ADR. Twelve English endoscopy units participated. All nominated a lead endoscopist and nurse. A model combining central training, locally led implementation, feedback and ongoing study team support was used. Colonoscopist's ADRs were measured for 3 months prior to implementation and for a 9 month period following. Colonoscopists performing greater than or equal to 25 procedures during the period before were ranked according to ADR and quartiles constructed. Change in Buscopan use was used as a surrogate marker for intervention uptake. A corrected Chi Squared test was used to check for significant change.ResultsOne hundred and eighteen and 68 colonoscopists were included in the global and quartile analyses. The study included 17508 colonoscopies, 4351 and 13157 in the pre and post intervention periods respectively. There was a significant global increase in buscopan use (15.8 vs. 54.4%, p < 0.001), also seen in each quartile, and ADR (16.0 vs. 18.1%, p = 0.002), Table 1.Abstract OC-062 Table 1 Before After QuartileNADR (%)NADR (%)Difference ratiop value ADRUpper78527.4250821.50.78