Consumer Healthcare Medical Affairs, Sanofi-Aventis Deutschland GmbH, Industriepark Hoechst, 65026, Frankfurt am Main, Germany.
Consumer Healthcare CMI, Sanofi-Aventis Deutschland GmbH, Industriepark Hoechst, Frankfurt am Main, 65026, Germany.
BMC Gastroenterol. 2020 Jun 17;20(1):191. doi: 10.1186/s12876-020-01338-4.
Constipation is often self-managed by patients and guidelines are available to aid healthcare professionals in the counseling of patients for self-management. Therefore, we have explored the knowledge and attitude of pharmacy personnel towards guidelines for the management of acute and functional chronic constipation and how they affects their recommendations.
An online survey was conducted among 201 pharmacists and pharmacy technicians from an existing panel. They were presented with two typical cases, a 62-year old woman with functional chronic constipation and a 42-year old woman with travel plans. For each case, they were asked about their treatment recommendations and the underlying rationale. Thereafter, they were provided with contents from an applicable national guideline and asked again about their recommendations and the underlying rationale. In line with the exploratory nature, data were analyzed in a descriptive manner only.
Before exposure to guideline content, the most frequent recommendations for chronic constipation were macrogol, fiber and lactulose and for acute constipation sodium picosulfate, bisacodyl and enemas. Following guideline exposure, the most frequent recommendations for chronic constipation were macrogol, bisacodyl and sodium picosulfate and for acute constipation bisacodyl, sodium picosulfate and macrogol (all three equally recommended by the guideline for the management of acute and chronic constipation). Correspondingly, the rationale behind the recommendations shifted with guideline conformity becoming a leading reason.
Awareness of the content of an applicable guideline on the management of constipation was poor among pharmacy personnel. Accordingly, recommendations in many cases were not in line with the guideline. Greater awareness of guideline content is desirable to enable more evidence-based recommendations in the management of constipation.
便秘通常由患者自行管理，并且有指南可帮助医疗保健专业人员为患者的自我管理提供咨询。因此，我们探讨了药剂人员对急性和功能性慢性便秘管理指南的知识和态度，以及这些知识和态度如何影响他们的建议。
我们对来自现有小组的 201 名药剂师和药剂技术员进行了在线调查。他们被介绍了两个典型案例，一个 62 岁的功能性慢性便秘女性和一个 42 岁的有旅行计划的女性。对于每个案例，他们被问到他们的治疗建议和潜在的基本原理。此后，向他们提供了一份适用的国家指南的内容，并再次询问他们的建议和潜在的基本原理。根据探索性的性质，仅以描述性方式分析数据。
在接触指南内容之前，慢性便秘最常见的建议是聚乙二醇、纤维和乳果糖，急性便秘最常见的建议是匹可硫酸钠、比沙可啶和灌肠剂。在接触指南内容之后，慢性便秘最常见的建议是聚乙二醇、比沙可啶和匹可硫酸钠，急性便秘最常见的建议是比沙可啶、匹可硫酸钠和聚乙二醇（这三种药物都是急性和慢性便秘管理指南推荐的）。相应地，建议背后的理由也随着与指南的一致性而发生转变，符合指南成为主要原因。
药剂人员对便秘管理适用指南内容的认识很差。因此，在许多情况下，建议并不符合指南。更了解指南内容是可取的，以便在便秘管理中做出更基于证据的建议。
