Table 4.

Methods to improve patient compliance and adherence to bowel preparations (ref. 45,46).

Clear instructions	Instructions in both verbal and written form Effective for a wide range of health literacy and education levels Education tools (booklets, visual aids, cell phone apps, etc.) that are standardized and valid
Instructions on product label for splitting the preparation	Current product instructions do not generally include split preparation instructions, these would need to be added by the pharmacy to the product
Pre-procedure phone calls	Clinic staff confirm that patient understands appointment date and diet instructions Verify split-preparation instructions and emphasize completing the entire volume Standardized templates are used for recording pre-calls in medical record Phone number for patients to call if they have questions, including instructions to page the GI fellow on call if they have questions the night before the procedure.
Alternative Preparation available	Availability of at least two alternative bowel preparation options. These would include a reduced volume preparation for patients who are unable to take a 4L preparation even if it is split (if no risk factors for renal disease), and an augmented regimen for patients that failed a previous preparation despite adequate compliance (e.g., two day low residue or clear liquid diet with 4 L PEG split prep with the addition of one bottle magnesium citrate the evening before; premedication with metochlopramide 20 mg to prevent nausea if no neurologic co-morbidity)