The Uniformed Services Constipation Action Plan: An Effective Tool for the Management of Children with Functional Constipation

To implement and to evaluate the effectiveness of the Uniformed Services Constipation Action Plan (USCAP) in our gastroenterology clinic for children with functional constipation. This implementation science study included toilet-trained subjects aged 4 years and older who met the Rome IV criteria f...

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Bibliographic Details
Published in:The Journal of pediatrics 2023-02, Vol.253, p.46-54.e1
Main Authors: Reeves, Patrick T., Jack, Benjamin O., Rogers, Philip L., Kolasinski, Nathan T., Burklow, Carolyn Sullivan, Min, Steve B., Nylund, Cade M.
Format: Article
Language:English
Subjects:
Ambulatory Care Facilities
Child
clinical action plan
Constipation
discharge planning
Female
functional constipation
health literacy
Humans
Male
Quality of Life
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Summary:To implement and to evaluate the effectiveness of the Uniformed Services Constipation Action Plan (USCAP) in our gastroenterology clinic for children with functional constipation. 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]). 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 
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2022.09.011