Background
High-quality bowel preparation is essential for accurate and safe colonoscopy. Demographic, medical, and socio-cultural factors may influence bowel preparation adequacy, particularly in regional and remote populations in Central Australia.
Methods
A retrospective cohort study was conducted on consecutive colonoscopies performed between March and August 2025 at Alice Springs Hospital. The primary outcome was mean Boston Bowel Preparation Scale (BBPS) score. Secondary outcomes included predictors of inadequate bowel preparation (BBPS < 6) using multivariable logistic regression.
Results
A total of 125 colonoscopies were included (35 First Nations and 90 non–First Nations patients). Mean BBPS was significantly lower among First Nations patients (6.0 ± 1.8 vs 7.8 ± 1.6; p < 0.001). Inadequate bowel preparation occurred in 28.6% of First Nations patients and 7.8% of non–First Nations patients (p = 0.002). Independent predictors of inadequate preparation included First Nations status, inpatient status, chronic kidney disease, travel distance greater than 200 km, and hospital-based preparation.
Conclusion
First Nations patients were significantly more likely to experience inadequate bowel preparation for colonoscopy. Addressing communication barriers, logistical challenges, and culturally appropriate education may improve preparation quality in remote healthcare settings.
Clinical Trial Registration
Not applicable.