Background and Aims There are a number of published guidelines on the management of childhood constipation. However, in many cases, the evidence base of these recommendations is unclear. Detailed guidance is expected from the UK National Institute for Health and Clinical Excellence (NICE) in May 2010. In this survey, we aimed to evaluate the consistency of current treatment decisions made for children with constipation and the extent to which these decisions are based on published guidance and evidence.
Methods Between September 2009 and October 2009, an online questionnaire was emailed to all consultant general paediatricians held on an email mailing list in the North West of England. The nine-item questionnaire was developed locally and piloted before its delivery using the online service “SurveyMonkey”. The questionnaire consisted mainly of closed questions, with some open ended questions to gather qualitative data. A reminder was sent 2 weeks after the initial email to encourage those who had not responded to do so. Responses were collected anonymously.
Results Forty eight of 70 consultant paediatricians (68.6%) in the North West of England replied. The mean length of time of being in a consultant post was 6.5 years (range, 1 month–27 years). 88% of responders reported seeing children with constipation in most or all of their clinics. Responders reported their most commonly used interventions as out-patient medical management (95%), advice and reassurance (89%) and the use of information leaflets (57%). Many responders commented on recent changes in their management of constipation, although these were largely reported to be based on anecdotal experience. 52% of responders reported that they did not use any forms of published evidence or guidance as the basis for their treatment choices.
Conclusion This survey indicates that there is consistency in the way general paediatricians manage children with constipation in the North West of England. The majority of paediatricians do not base their management decisions on published evidence or guidelines and instead adopt an anecdotal and opinion-based approach.
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