Constipation Action Plan: Better Instructions, Fewer Phone Calls

K Hawa et al. JPGN 2022; 75: 589-594. Providing a Constipation Action Plan to Families of Children With Constipation Decreases Health Care Utilization

This retrospective review examined health care utilization within 3 months before and after patients received a constipation action plan (CAP which was implemented in 2019). There were 336 patients who received a CAP and 2812 patients who did not.

Key findings:

  • There were fewer patient telephone calls for patients who received the CAP (P = 0.0006). The difference in patient electronic messages was not statistically significant (P = 0.09).
  • There were no differences in UC/emergency department visits or hospitalizations.

Medications for CAP included the following:

  • Polyethylene glycol 3350, Senna, Milk of Magnesia, Magnesium Citrate, Lactulose, Bisacodyl (tablets, suppository, enema), Normal saline enema, Glycerin suppository, and Sodium phosphate enema

My take: A CAP likely helps educate and empower families on how to manage their child’s symptoms. In this study, it resulted in fewer phone calls (& trend of less electronic messages). Better education is likely to help with patient outcomes even if this is difficult to prove in a retrospective study. This action plan appears easier to understand than a previous CAP, and uses the Red Zone as the cleanout section. Related blog post: Pictographic Constipation Action Plan (2021)

This is a sample of the institution’s constipation action plan (similar to Figure 1) shared by the author.