Efficacy and safety of split-dose ultra-low-volume polyethylene glycol with ascorbic acid versus sodium picosulfate with magnesium citrate for bowel preparation: a systematic review and meta-analysis.

Key Takeaways for GI Nurses

• This meta-analysis directly compares two commonly used bowel preparation regimens in split-dose formats, providing evidence-based guidance for patient preparation protocols
• Understanding the comparative efficacy and safety profiles of ultra-low-volume PEG with ascorbic acid versus sodium picosulfate with magnesium citrate helps nurses provide informed patient education and anticipate potential adverse effects
• Split-dose administration timing and patient compliance monitoring remain critical nursing responsibilities regardless of which preparation is selected
• Safety profile differences between these preparations may influence pre-procedure risk assessment and patient monitoring protocols

Clinical Relevance

This systematic review and meta-analysis addresses a practical question that endoscopy nurses encounter daily: which bowel preparation offers the best balance of efficacy and tolerability for patients. Both ultra-low-volume PEG with ascorbic acid and sodium picosulfate with magnesium citrate are frequently prescribed preparations, and understanding their comparative performance helps nurses optimize patient education, preparation protocols, and pre-procedure assessments. The split-dose methodology examined in this study aligns with current best practices that many endoscopy units have already implemented to improve preparation quality and patient tolerance.

For nursing practice, this research impacts several key areas including patient counseling, preparation instruction delivery, and adverse event monitoring. Nurses play a crucial role in explaining preparation procedures to patients, addressing concerns about taste and volume, and providing strategies to improve compliance. When evidence demonstrates differences in efficacy or safety between preparations, this information directly influences how nurses structure their patient education and what specific monitoring parameters they emphasize during pre-procedure calls and assessments.

From an operational perspective, understanding the comparative effectiveness of different bowel preparations can influence unit protocols, stock management decisions, and quality improvement initiatives. If one preparation consistently demonstrates superior cleansing with fewer adverse effects, this may inform formulary decisions and standardization efforts. Additionally, preparation-specific adverse event profiles help nurses anticipate and proactively manage patient concerns, potentially reducing last-minute preparation failures and procedure cancellations.

Bottom Line

This meta-analysis provides GI nurses with evidence-based comparative data on two widely used split-dose bowel preparations, enabling more informed patient education and preparation protocol optimization. While both ultra-low-volume PEG with ascorbic acid and sodium picosulfate with magnesium citrate are established options, understanding their relative efficacy and safety profiles allows nurses to better counsel patients, anticipate potential issues, and contribute to evidence-based preparation selection decisions that ultimately improve procedure outcomes and patient experience.