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Patient barriers and facilitators of colonoscopy use: A rapid systematic review and thematic synthesis of the qualitative literature

Kerrison, RS; Sheik-Mohamud, D; McBride, E; Whitaker, KL; Rees, C; Duffy, S; von Wagner, C; (2021) Patient barriers and facilitators of colonoscopy use: A rapid systematic review and thematic synthesis of the qualitative literature. Preventive Medicine , Article 106413. 10.1016/j.ypmed.2020.106413. (In press).

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Abstract

Colonoscopy is the gold standard test in the diagnosis of colorectal cancer. Despite this, many people across the world decline the procedure when invited for screening, surveillance or diagnostic evaluation. The aim of this review was to characterise the barriers and facilitators of colonoscopy use described in the qualitative literature. We searched PubMed and PsychInfo for studies that explored barriers and facilitators of colonoscopy use. To determine the eligibility of studies, we first reviewed titles, then abstracts, and finally the full paper. We started with a narrow search, which we expanded successively, until the number of new publications eligible after abstract review was <1% of the total number of publications identified. Papers were eligible if they: 1) focussed on an adult population, 2) used a qualitative research design and, 3) described at least one patient-related theme regarding colonoscopy use. We then extracted qualitative data from eligible papers and analysed using thematic synthesis. Fifty-seven studies met the inclusion criteria. Most explored barriers and facilitators of screening colonoscopy (n=53, 93.0%) and were conducted in the USA (n=48, 84.2%). Key psychological and social factors included: ‘fear of pain and discomfort’, ‘concerns about doing the bowel preparation’, and whether the test was recommended by the patient's physician. Key practical factors included cost, and whether colonoscopy was covered by the patient's healthcare insurance. Studies mostly focussed on screening colonoscopy in the USA, where there is no universal healthcare coverage. To better understand the barriers and facilitators in other contexts, further research is needed.

Type: Article
Title: Patient barriers and facilitators of colonoscopy use: A rapid systematic review and thematic synthesis of the qualitative literature
Location: United States
DOI: 10.1016/j.ypmed.2020.106413
Publisher version: https://doi.org/10.1016/j.ypmed.2020.106413
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Barriers, Colonoscopy, Diagnosis, Facilitators, Review, Screening, Surveillance, Thematic synthesis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10118604
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