The Uniformed Services Constipation Action Plan: An Effective Tool for the Management of Children with Functional Constipation - 15/03/23
, Benjamin O. Jack, MD 1, Philip L. Rogers, MD 1, 2, Nathan T. Kolasinski, MD 1, 2, Carolyn Sullivan Burklow, MD 1, 2, Steve B. Min, MD 1, 2, Cade M. Nylund, MD 1, 2Abstract |
Objective |
To implement and to evaluate the effectiveness of the Uniformed Services Constipation Action Plan (USCAP) in our gastroenterology clinic for children with functional constipation.
Study design |
This implementation science study included toilet-trained subjects aged 4 years and older who met the Rome IV criteria for functional constipation. Children were block randomized to receive either the USCAP or control. All clinic functional constipation plans recommended subjects continue pharmacotherapy for 4 months. Endpoints measured were clinical outcomes (resolution of functional constipation and achievement of a Pediatric Bristol Stool Form Scale [PBSFS] score of 3 or 4), patient-related outcomes (health-related quality of life [HRQoL] total scale score), and health confidence outcomes (Health Confidence Score [HCS]).
Results |
Fifty-seven treatment group subjects (44%) received a USCAP (52% male; mean age, 10.9 [4.9] years) compared with 73 controls (56%; 48% male; mean age,10.9 [5.3] years). A PBSFS score of 3 or 4 was achieved by 77% of the treatment group compared with 59% of controls (P = .03). Subjects from the treatment group were more likely than the controls to endorse adherence to the 4-month course of pharmacotherapy (P < .001). Subjects who received a USCAP had greater improvements in HRQoL total scale score by the end of the project (P = .04).
Conclusions |
The USCAP is a simple, inexpensive tool that has the potential to improve global outcomes for functional constipation in children and should be recommended as standard clinical practice.
Le texte complet de cet article est disponible en PDF.Keywords : functional constipation, health literacy, clinical action plan, discharge planning
Abbreviations : DPMD, HCS, HRQoL, PBSFS, PedsGIQL, USCAP
Plan
| This work was prepared as part of the official duties of P.R., B.J., N.K., P.R., C.B., S.M., and C.N., who are employed by the US Army, Air Force, and Department of Defense. The views expressed in this article are those of the authors and do not reflect the official policy or position of the US Army, Air Force, Department of Defense, or Government. Salary support was provided for P.R., B.J., N.K., P.R., C.B., S.M., and C.N. by the US Department of Defense. The authors declare no conflicts of interest. |
Vol 253
P. 46 - février 2023 Retour au numéro
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