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. 2018 Dec;64(12):e553-e560.

Alberta Family Physician Electronic Endoscopy study: Quality of 1769 colonoscopies performed by rural Canadian family physicians

Michael R Kolber  1 , Nicole Olivier  2 , Oksana Babenko  3 , Ryan Torrie  4 , Lee Green  5
Affiliations

Alberta Family Physician Electronic Endoscopy study: Quality of 1769 colonoscopies performed by rural Canadian family physicians

Michael R Kolber et al. Can Fam Physician. 2018 Dec.

Abstract
in English, French

Objective: To determine whether rural FP colonoscopists in Alberta are achieving benchmarks in colonoscopy quality.

Design: Prospective, multicentre observational study.

Setting: Alberta.

Participants: Nine FP colonoscopists.

Main outcome measures: Proportion of successful cecal intubations; proportion of patients aged 50 and older with pathologically confirmed adenomas; mean number of adenomas per colonoscopy; and serious adverse events related to colonoscopy.

Results: In this 6-month study, 9 rural FPs in Alberta performed 1769 colonoscopies. Overall, all key colonoscopy quality benchmarks were met or exceeded. The proportion of successful cecal intubations was 97.9% (95% CI 97.2% to 98.6%). The proportion of male and female patients aged 50 and older whose first-time colonoscopy results revealed an adenoma was 67.4% (95% CI 62.4% to 72.7%) and 51.1% (95% CI 45.5% to 56.7%), respectively. There were 120 adenomas, 36 advanced adenomas, and 1 colon cancer case per 100 colonoscopies. There were 2 postpolypectomy bleeds and no other serious complications.

Conclusion: Alberta rural FP colonoscopists are meeting benchmarks in colonoscopy quality. Ongoing electronic collection of endoscopy quality markers should be encouraged. Supporting and training rural FPs who perform endoscopy might help alleviate current wait times and improve access for rural Canadian patients.

Objectif: Déterminer si les médecins de famille qui effectuent des colonoscopies en Alberta satisfont aux critères de qualité d’une telle intervention.

Conception: Étude observationnelle prospective multicentrique.

Contexte: Alberta.

Participants: Neuf médecins de famille qui effectuent des colonoscopies.

Principaux paramètres à l’étude: La proportion d’intubations cæcales réussies; la proportion de patients de 50 ans et plus chez qui on a trouvé des adénomes confirmés en pathologie; le nombre moyen d’adénomes par colonoscopie; les événements indésirables graves liés à la colonoscopie.

Résultats: Dans cette étude d’une durée de 6 mois, 9 médecins de famille en milieu rural en Alberta ont exécuté 1769 colonoscopies. Dans l’ensemble, tous les principaux critères de qualité d’une colonoscopie ont été atteints ou surpassés. La proportion d’intubations cæcales réussies était de 97,9 % (IC à 95 % de 97,2 à 98,6 %). La proportion d’hommes et de femmes de 50 ans ou plus dont la toute première colonoscopie a révélé un adénome était respectivement de 67,4 % (IC à 95 % de 62,4 à 72,7 %) et de 51,1 % (IC à 95 % de 45,5 à 56,7 %). On a compté 120 adénomes, 36 adénomes à un stade avancé et 1 cas de cancer du côlon par tranche de 100 colonoscopies. On a dénombré 2 hémorragies à la suite d’une polypectomie et aucune complication sérieuse.

Conclusion: Les médecins de famille en milieu rural qui effectuent des colonoscopies en Alberta respectent les normes de qualité d’une telle intervention. Il y a lieu d’encourager une collecte électronique continue des marqueurs de qualité. Le soutien et la formation des médecins de famille ruraux qui exécutent des colonoscopies pourraient réduire les temps d’attente actuels et améliorer l’accès des patients canadiens en milieu rural.

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References

    1. Hilsden RJ, Tepper J, Moayyedi P, Rabeneck L. Who provides gastrointestinal endoscopy in Canada? Can J Gastroenterol. 2007;21(12):843–6. - PMC - PubMed
    1. College of Family Physicians of Canada. Canadian Medical Association. Royal College of Physicians and Surgeons of Canada . National Physician Survey 2004. Mississauga, ON: College of Family Physicians of Canada; 2004. Available from: http://nationalphysiciansurvey.ca/wp-content/uploads/2012/10/NPS2004-Nat.... Accessed 2018 Nov 1.
    1. Kolber MR, Wong CK, Fedorak RN, Rowe BH, APC-Endo Study Physicians Prospective study of the quality of colonoscopies performed by primary care physicians: the Alberta Primary Care Endoscopy [APC-Endo] study. PLoS One. 2013;8(6):e67017. - PMC - PubMed
    1. Kolber M, Szafran O, Suwal J, Diaz M. Outcomes of 1949 endoscopic procedures. Performed by a Canadian rural family physician. Can Fam Physician. 2009;55:170–5. - PMC - PubMed
    1. Wilkins T, LeClair B, Smolkin M, Davies K, Thomas A, Taylor ML, et al. Screening colonoscopies by primary care physicians: a meta-analysis. Ann Fam Med. 2009;7(1):56–62. Erratum in: Ann Fam Med 2009;7(2):181. - PMC - PubMed