Authors: (including presenting author): :
Lin HS(1), Fong TS(1), Chan WYM(1), Mak CK(1), Mak LKK(1), Lai WCJ(2), Yeung CK(2), Li YYJ(3), Leung YYC(3)
Affiliation: :
(1)Department of Pharmacy, Tseung Kwan O Hospital, (2)Department of Medicine, Tseung Kwan O Hospital, (3)Department of Surgery, Tseung Kwan O Hospital
Keyword 1: :
Pharmacist clinic
Keyword 3: :
Patient education
Keyword 4: :
Medication safety
Keyword 5: :
Procedure quality
Introduction: :
Elective colonoscopy is usually scheduled months to years after initial booking, during which patients’ medications and conditions may have changed. The long interval could predispose patients to misunderstandings about bowel preparation and pre-procedure medication instructions. Suboptimal bowel preparation has been associated with procedural incompletion, while inappropriate medication management can cause adverse outcomes. Clinical trials demonstrated that reinforced patient education shortly before colonoscopy improved bowel cleanliness and compliance. Through structured pre-colonoscopy consultation, pharmacists could enhance patients’ understanding, adherence and safety.
Objectives: :
The project aimed to enhance pre-colonoscopy care via a pharmacist-led service to: 1) improve patient understanding of bowel preparation and pre-colonoscopy medication management; and 2) enhance medication safety and reduce preventable medication-related colonoscopy cancellations.
Methodology: :
A new pre-colonoscopy consultation service through the Pharmacist Gastrointestinal Clinic was launched in October 2024 at Tseung Kwan O Hospital. Gastroenterologists and surgeons referred patients taking concerned medications (antiplatelets, anticoagulants, SGLT-2 inhibitors, iron supplements) prior to colonoscopy to the clinic. Following the pre-endorsed protocol, pharmacists reviewed patients’ latest drug profiles, assessed their understanding of pre-colonoscopy preparation, provided counselling and written instructions, and rectified misconceptions. If patients’ conditions required medical attention or drug-related problems were identified, pharmacists would seek advice from gastroenterologists or surgeons. Consultations were conducted one to two weeks before scheduled colonoscopy and service data were collected.
Result & Outcome: :
By October 2025, 222 patients had attended the clinic. Substantial misunderstanding was found regarding diet restriction (72%), bowel preparation use (61%), and management of SGLT-2 inhibitors (71%), iron supplements (67%), antiplatelets (31%) and other medications (41%) prior to colonoscopy. With pharmacist consultation, 99% withheld medications correctly, with only two cases showing non-compliance to their drug management. Moreover, two patients were identified with changes of medical or medication profiles requiring modification of colonoscopy arrangement. Among patients underwent colonoscopy after pharmacist consultation, more than 70% achieved a Boston Bowel Preparation Scale score ≥6, indicating adequate bowel preparation. These findings indicated pharmacist consultation was able to rectify patient misunderstanding, and potentially reduce the risk of incomplete procedures and rescheduling. The service highlighted the value of multidisciplinary gastrointestinal care.
