The following is a summary of “Uniformed Services Constipation Action Plan: An Effective Tool for the Management of Children with Functional Constipation,” published in the FEBRUARY 2023 issue of Pediatrics by Reeves, et al.
For a study, researchers sought to evaluate the effectiveness of the Uniformed Services Constipation Action Plan (USCAP) in improving clinical, patient-related, and health confidence outcomes for children with functional constipation in a gastroenterology clinic.
An implementation science study included toilet-trained children aged 4 years and older who met the Rome IV criteria for functional constipation. The children were block randomized to receive either the USCAP or no intervention (control). All functional clinic constipation plans recommended subjects continue pharmacotherapy for 4 months. Clinical outcomes measured were the resolution of functional constipation and the achievement of a Pediatric Bristol Stool Form Scale (PBSFS) score of 3 or 4. Patient-related outcomes measured were health-related quality of life (HRQoL) total scale score, and health confidence outcomes measured were the Health Confidence Score (HCS).
A total of 130 children were included in the study, with 57 (44%) in the treatment group (52% male; mean age, 10.9 [4.9] years) and 73 controls (56%; 48% male; mean age, 10.9 [5.3] years). The USCAP group had a higher percentage of children achieving a PBSFS score of 3 or 4 (77%) compared to controls (59%) (P = .03). The USCAP group was also more likely to adhere to the 4-month course of pharmacotherapy (P < .001). In addition, children in the USCAP group had greater improvements in HRQoL total scale score at the end of the project (P = .04).
The USCAP is a simple, inexpensive tool that can potentially improve clinical, patient-related, and health confidence outcomes for children with functional constipation in a gastroenterology clinic. The USCAP should be recommended as standard clinical practice.
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