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Naomi C Sacks,1,2 Abhishek Sharma,1 Philip L Cyr,1,3 Gerald Bertiger,4 David N Dahdal,5 Stuart P Brogadir5 1Precision Xtract, Boston, MA, USA; 2Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; 3College of Health and Human Services, University of North Carolina, Charlotte, NC, USA; 4Hillmont GI, Flourtown, PA, USA; 5Ferring Pharmaceuticals Inc., Parsippany, NJ, USA Background and aims: Proper bowel cleansing is necessary prior to colonoscopy, but poor tolerability to bowel preparation agents may increase the odds of poor cleansing and incomplete screenings. The aim of this study was to evaluate the real-world effectiveness and safety of bowel preparation agents. Methods: Claims data were extracted for individuals who had a screening colonoscopy from July 1, 2012, to June 30, 2015, were ≥18 years of age, and who could be observed ≥6 months before and ≥3 months after the screening. Data were stratified by agent class, including over-the-counter (OTC), low-volume (LV), and high-volume (HV) agents. Rates of incomplete screenings, repeat screenings, and hospitalizations were reported. Multivariate logistic regression was conducted to compare outcomes for sodium picosulfate, magnesium oxide, and citric acid (P/MC) vs other agents. Results: Of 2.8 million individuals, 71.5% were average risk and 28.5% were high risk for colorectal cancer. Rates of use were 2.8% for P/MC, 30.1% for other LV agents, 9.4% for HV agents, and 56.6% for OTC agents. All individuals who used P/MC had significantly lower odds of incomplete screenings compared to those who used other LV agents or HV agents (P