Department of Pediatrics, Tergooi Hospitals, Rijksstraatweg 1, 1261 AN, Blaricum, The Netherlands.
Department of Pediatrics, BovenIJ Hospital, Amsterdam, The Netherlands.
Indian J Gastroenterol. 2022 Aug;41(4):369-377. doi: 10.1007/s12664-022-01253-4. Epub 2022 Sep 3.
Approximately 90% of the children with chronic abdominal pain are diagnosed as having functional abdominal pain disorder (FAPD). The Dutch guideline "functional abdominal pain" provides a stepwise approach to treat FAPD. The aim of this survey was twofold first, to determine adherence to the Dutch guideline, and second to determine current management of FAPDs in clinical practice.
A multicenter survey was designed. The survey was sent to pediatricians and pediatric residents in December 2020. The study ran from October 2020 until March 2021. Participants in ten hospitals in the western region of The Netherlands were invited to complete this survey. Respondents who indicated not to treat children with FAPDs or respondents who completed less than 3 steps of the survey were excluded.
In total, 85/174 (48.9%) respondents completed the survey. We included 80 respondents, 68 pediatricians and 12 pediatric residents, for analysis. Overall, self-reported guideline adherence was 85%. Self-reported adherence was higher than actual adherence. Only 50% of all respondents followed the first three steps of the guideline. The reported non-pharmacological and pharmacological treatments were diverse and varied between different age groups. The average follow-up duration was between 2 and 6 months, and the most regularly used outcome measures were attendance at school, quality of life, and adequate pain relief/reassurance.
We reportedly observed a large variation in the management of children with FAPDs, due to low guideline adherence among clinicians. Improved guideline adherence may be accomplished by updating the guideline with specific recommendations per subtype, follow-up and outcome measures as well measures to improve guideline implementation.
大约 90%的慢性腹痛儿童被诊断为功能性腹痛障碍（FAPD）。荷兰指南“功能性腹痛”提供了一种逐步治疗 FAPD 的方法。本调查的目的有两个，首先是确定对荷兰指南的遵循情况，其次是确定临床实践中 FAPD 的当前管理情况。
设计了一项多中心调查。该调查于 2020 年 12 月发送给儿科医生和儿科住院医师。该研究于 2020 年 10 月至 2021 年 3 月进行。邀请荷兰西部地区的十家医院的参与者完成此项调查。被指示不治疗 FAPD 儿童的受访者或完成调查步骤少于 3 步的受访者被排除在外。
共有 85/174（48.9%）名受访者完成了调查。我们纳入了 80 名受访者，68 名儿科医生和 12 名儿科住院医师进行分析。总体而言，自我报告的指南遵循率为 85%。自我报告的遵循率高于实际遵循率。只有 50%的受访者遵循了指南的前三个步骤。报告的非药物和药物治疗方法多种多样，且在不同年龄组之间有所不同。平均随访时间为 2 至 6 个月，最常使用的结局指标是上学出勤率、生活质量和适当的疼痛缓解/缓解。
由于临床医生对指南的遵循程度较低，我们观察到儿童 FAPD 的管理存在很大差异。通过更新指南，为每种亚型提供具体建议、随访和结局措施以及改善指南实施的措施，可能会提高指南的遵循程度。
