Researchers aimed to determine if outpatient gastroenterology (GI) service utilization was affected when parents of constipated children were given a constipation action plan (CAP) during routine doctor visits. To compile a post-visit summary of the GI Clinic patients’ children, investigators developed a CAP. Using inverse probability treatment weighting (IPTW) analysis, they compared the number of patient calls, electronic messages, urgent care (UC) visits, emergency department (ED) visits, and hospitalizations that occurred within 3 months of the initial visit between those who received the CAP and those who did not. Using the paired t test and the McNemar’s test, they compared these factors in the 3 months before and after the CAP was delivered to families that received it during a follow-up visit.
There were 336 patients in the CAP group and 2,812 in the non-CAP group. The number of patient phone calls decreased for those who were given the CAP after the IPTW was modified (P=0.0006). No statistically significant difference was found in electronic messages from patients (P=0.09). There were an average of 1.8 more telephone calls from patients before receiving the CAP than after (95% CI = 0.8-2.8; P=0.0007), and an average of 2.3 more electronic messages from patients before receiving the CAP than after (95% CI = 0.1-4.5; P=0.04), among the 45 patients who received the CAP at a follow-up visit. Hospitalizations and visits to UCs or EDs were not different.
Providing a CAP to families with children who are constipated reduces their need for medical attention, as confirmed by the study. Patient outcomes may be affected, however this needs more research to confirm.