Education improves colonoscopy appropriateness

Background Appropriateness in GI endoscopy is critical to face the rising amount of demands. Education of physicians has been advocated to reduce the level of inappropriateness. Objective Our purpose was to assess the effectiveness of an educational program in determining a reduction of inappropriate colonoscopies in an open access system. Design Prospective study. Setting A single endoscopy unit in Italy. Patients A total of 495 consecutive outpatients referred to our endoscopy unit by family physicians for diagnostic colonoscopy before the educational course and 522 after its completion, for a total of 1017 patients. Main Outcome Measurements Inappropriate colonoscopy reduction rates, cost savings, and reduction of waiting lists were evaluated. Results With regard to inappropriate colonoscopies, the post-course group rate of inappropriateness was significantly lower than that of the pre-course group ( P ≤ .001). The economic savings for 1 year was estimated to be €19,000. The reduction of the waiting list was about 15% of the original value. Conclusions Education has a high incidence in reducing inappropriate colonoscopies in an open-access system determining reduction of costs and waiting lists.