Nurse management of intractable functional constipation: a randomised controlled trial

Area of Science:

• Pediatric Gastroenterology
• Clinical Nursing
• Healthcare Management

Background:

• Chronic constipation is a common pediatric issue requiring effective management strategies.
• Current management often involves specialized consultant-led clinics.

Purpose of the Study:

• To compare the effectiveness of nurse-led clinics (NLCs) versus consultant-led paediatric gastroenterology clinics (PGCs) for pediatric chronic constipation.
• To evaluate cure rates and time to cure in both clinic models.

Main Methods:

• A randomized controlled trial involving 102 children (ages 1-15) with functional constipation.
• Children were assigned to either an NLC or PGC, both utilizing an escalating treatment algorithm.
• Outcomes included time to cure and premature study withdrawal.

Main Results:

• Children in the NLC group showed a higher cure rate (34/52) compared to the PGC group (25/50).
• The median time to cure was shorter in the NLC (18.0 months) versus the PGC (23.2 months).
• The probability of cure was estimated to be 33% higher in NLCs, with cure hastened by 18.4%.

Conclusions:

• Nurse-led clinics are as effective, if not more so, than consultant-led clinics for treating intractable constipation in children.
• NLCs can significantly improve follow-up care and highlight the crucial role of clinic nurse specialists in pediatric gastrointestinal disease management.