Original ArticleAlimentary TractImpact of Physicians’ and Patients’ Compliance on Outcomes of Colonoscopic Polypectomy With Anti-Thrombotic Therapy
Section snippets
Study Design and Population
The colonoscopy registry, which was established in December 2017, is an ongoing, prospective, noninterventional database maintained in a tertiary referral center that serves a local population of 1.5 million in Hong Kong. Patients scheduled to undergo an elective colonoscopy were eligible if the following inclusion criteria were met: (1) age older than 18 years; (2) on antithrombotic drugs (antiplatelet agents, dual-antiplatelet therapy [DAPT], or anticoagulants) at the time of colonoscopy; and
Results
From December 2017 to October 2019, there were 999 patients screened who were on long-term antithrombotic therapy who underwent a complete colonoscopy. A total of 378 cases were excluded because of an absence of polyps. Another 19 cases were excluded because a polypectomy was not performed. A total of 602 patients with a complete colonoscopic polypectomy were recruited and analyzed (Figure 1). The use of antithrombotic drugs included aspirin (72.4%), direct oral anticoagulants (DOACs) (16.1%),
Discussion
Our prospective study showed that physician adherence to guideline and patient compliance in Hong Kong, with the exception of aspirin, were poor and clinician nonadherence contributed to the occurrence of adverse clinical outcomes, namely delayed postpolypectomy bleeding and serious cardiovascular events.
The results of our study are relevant for a number of reasons. We noted a low compliance rate to guidelines by clinicians when managing patients on antithrombotics periendoscopically,
CRediT Authorship Contributions
Wei Jiang (Writing – original draft: Lead)
Bing Yee Suen (Data curation: Lead)
Hiu Tung Ho (Investigation: Lead)
Jessica Yuet Ling Ching (Conceptualization: Equal; Methodology: Equal)
Francis Ka Leung Chan (Supervision: Lead)
Wing Yan Mak, MD (Supervision: Lead)
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Conflicts of interest The authors disclose the following: Francis K. L. Chan has received speakers honoraria from AstraZeneca and Eisai, and educational grants from Olympus, Ltd, and Pfizer; and Joyce W. Y. Mak has received educational grants from Janssen. The remaining authors disclose no conflicts.