Adherence to post-polypectomy surveillance guidance in a tertiary care hospital-a clinical audit

Introduction

BSG post-polypectomy surveillance guidelines were introduced in 2020. The patients with high-risk findings were defined and were advised to have one off 3-year surveillance colonoscopy. Adherence to the post-polypectomy surveillance guidelines is recommended to be audited annually. We aimed to audit after a year of the published guidelines to assess adherence and compliance with the guidelines.

Methods

Aim

To assess compliance and adherence to the post-polypectomy guidelines at a tertiary care referral endoscopy center over 2 months after 1 year of guidelines publication. We analyzed all the patients who underwent Colonoscopies in the months of December 2021 and January 2022 at the endoscopy unit of Ambulatory Care Center Hamad Medical Corporation Doha, Qatar. A total of 284 patients had a colonoscopy with a polyp detected. We Audited 150 continuous patients.

Results

A total of 123 (82%) patients had complete data out of 150 patients audited. An Adenoma was detected in 74 (60.2%) patients while 49 (39.8%) patients had hyperplastic polyps. 28 patients had high-risk findings while 46 patients had low-risk adenomas. Among the 28 high-risk findings, patients 7 (25%) patients had no documentation on surveillance recommendations either on endoscopy reports or clinic notes/letters. Among 28 high-risk findings, patient 8 (28.5%) had recommendations on endoscopy report while 13 (46.5%) patients had surveillance recommendations mentioned in clinic/post-biopsy review. Out of 28 endoscopists seven (25%), different endoscopists were found to have non-compliance, with one endoscopist on 2 different occasions.

Conclusions

The compliance with post-polypectomy surveillance guidelines is below the standard recommendations in high-risk category patients. The audit highlights the need for ongoing education and reinforcement of guidelines to ensure optimal patient care. Exploration of factors for non-compliance is required for the improvement to meet the quality standards. Further studies are recommended to assess the long-term impact of adherence to BSG guidelines on patient outcomes.