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The clinical effectiveness of Movicol in children with severe constipation: an outcome audit
1Children's Resource Centre, Darent Valley Hospital, Kent.
Insights
Polyethylene glycol 3350 plus electrolytes (PEG+E) effectively managed severe pediatric constipation, reducing hospital admissions and home visits. This treatment, combined with a support service, proved clinically and economically beneficial for children.
Area of Science:
- Pediatric Gastroenterology
- Clinical Audit
- Pharmacological Management
Background:
- Severe pediatric constipation poses significant clinical and economic burdens.
- Existing treatments may have limitations in effectiveness and patient adherence.
- The role of polyethylene glycol 3350 plus electrolytes (PEG+E) in severe cases requires further evaluation.
Purpose of the Study:
- To audit the clinical effectiveness of PEG+E (Movicol) for severe pediatric constipation.
- To assess the impact of a community children's nursing team (CCNT) support service.
- To evaluate parental satisfaction and resource utilization with PEG+E treatment.
Main Methods:
- A seven-day disimpaction regimen followed by maintenance PEG+E dosing.
- Parental questionnaires assessed previous and current treatment experiences.
- Data collected on bowel movements, hospital admissions, home visits, and support service utilization.
Main Results:
- Prior to PEG+E, 57% of children required hospital admission and 26% home visits for constipation.
- Post-treatment, no children needed hospital admission or home visits.
- 96% of parents reported high satisfaction with constipation control using PEG+E.
Conclusions:
- PEG+E is clinically effective in managing severe pediatric constipation.
- Integrating a CCNT support service enhances treatment outcomes and parental satisfaction.
- PEG+E treatment, with support, offers both clinical and economic advantages.
Abstract:
This audit reviewed the clinical effectiveness of polyethylene glycol 3350 plus electrolytes (PEG+E, Movicol) in the management of severe paediatric constipation. A seven-day disimpaction regimen was initiated followed by a maintenance dose as appropriate. An information and support service was provided by the community children's nursing team (CCNT) at Darent Valley Hospital. Twenty-three parents completed questionnaires on their children's experiences with previous and current laxative treatments, bowel movement status, in-patient admissions or home visits required and the perceived value of the back up service. The mean age of children studied was 6.7 years. Prior to PEG+E treatment, 57 per cent of children were admitted to hospital and 26 per cent required home visits for constipation treatment. After treatment, no child needed either intervention. Thirty-nine percent of parents used the support service, of which 96 per cent rated the information it provided as adequate. When asked about their satisfaction with the control of their children's constipation, 96 per cent of parents were 'more than happy' after treatment with PEG+E. The treatment of severe paediatric constipation with PEG+E in conjunction with a support and advice service was both clinically and economically effective.
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