Skip to main content
Top
Published in: Digestive Diseases and Sciences 12/2010

01-12-2010 | Original Article

Prescribing Patterns for the Outpatient Treatment of Constipation in the United States

Authors: Katy E. Trinkley, Kyle Porter, Milap C. Nahata

Published in: Digestive Diseases and Sciences | Issue 12/2010

Login to get access

Abstract

Background

The incidence of constipation is rising. National data on the prescribing of pharmacologic and nonpharmacologic therapies, or factors influencing the prescribing of therapies for constipation are limited.

Aims

This study was designed to (1) identify prescribing patterns for constipation, and (2) determine associations between prescribing patterns and demographic variables among US outpatients.

Methods

This was a retrospective cross-sectional study utilizing data from the National Ambulatory Medical Care Survey (NAMCS) from 1997 to 2006 on constipation treatment trends across different age groups. Information collected from each visit included demographic data, pharmacologic and nonpharmacologic therapies for constipation. To assess for trends, the data for 1997–2001 and 2002–2006 were compared.

Results

A total of 52.7 million patient visits were related to constipation. Treatments prescribed were medication and nonpharmacologic therapies for 17% of visits, medications for 21%, nonpharmacologic therapies for 23%, and no therapy for 39%. From 1997–2001 to 2002–2006, the prescribing of medications increased 12% and nonpharmacologic therapies decreased 6%; hyperosmolars increased 15% and saline laxatives decreased 3%. Within the age groups, factors associated with prescribing included gender, ethnicity, race, physician specialty, and region.

Conclusions

Prescribing of medications increasingly replaced nonpharmacologic therapies. Hyperosmolars were prescribed most frequently and increased over time.
Literature
1.
go back to reference Martin BC, Barghout V, Cerulli A. Direct medical costs of constipation in the United States. Manag Care Interface. 2006;19:43–49.PubMed Martin BC, Barghout V, Cerulli A. Direct medical costs of constipation in the United States. Manag Care Interface. 2006;19:43–49.PubMed
2.
go back to reference Glaser M, Chi J. Thirty-fifth annual report on consumer spending. Drug Topics. 1983;126:18–20. Glaser M, Chi J. Thirty-fifth annual report on consumer spending. Drug Topics. 1983;126:18–20.
3.
go back to reference Sonnenberg A, Everhart JE, Brown DM. The economic cost of constipation. In: Kamm MA, Lennard-Jones JE, eds. Constipation. Bristol, PA: Wrightson Biomedical Pub Ltd; 1994:19–29. Sonnenberg A, Everhart JE, Brown DM. The economic cost of constipation. In: Kamm MA, Lennard-Jones JE, eds. Constipation. Bristol, PA: Wrightson Biomedical Pub Ltd; 1994:19–29.
4.
go back to reference Wald A, Scarpignato C, Kamm MA, et al. The burden of constipation on quality of life: results of a multinational survey. Aliment Pharmacol Ther. 2007;26:227–236.CrossRefPubMed Wald A, Scarpignato C, Kamm MA, et al. The burden of constipation on quality of life: results of a multinational survey. Aliment Pharmacol Ther. 2007;26:227–236.CrossRefPubMed
5.
go back to reference Sonnenberg A, Koch TR. Physician visits in the United States for constipation: 1958 to 1986. Dig Dis Sci. 1989;34:606–611.CrossRefPubMed Sonnenberg A, Koch TR. Physician visits in the United States for constipation: 1958 to 1986. Dig Dis Sci. 1989;34:606–611.CrossRefPubMed
6.
go back to reference Locke GR 3rd, Pemberton JH, Phillips SF. AGA technical review on constipation. American Gastroenterological Association. Gastroenterology. 2000;119:1766–1778.CrossRefPubMed Locke GR 3rd, Pemberton JH, Phillips SF. AGA technical review on constipation. American Gastroenterological Association. Gastroenterology. 2000;119:1766–1778.CrossRefPubMed
7.
go back to reference Woolery M, Bisanz A, Lyons HF, et al. Putting evidence into practice: evidence-based interventions for the prevention and management of constipation in patients with cancer. Clin J Oncol Nurs. 2008;12:317–337.CrossRefPubMed Woolery M, Bisanz A, Lyons HF, et al. Putting evidence into practice: evidence-based interventions for the prevention and management of constipation in patients with cancer. Clin J Oncol Nurs. 2008;12:317–337.CrossRefPubMed
8.
go back to reference van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101:2401–2409.CrossRefPubMed van den Berg MM, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: a systematic review. Am J Gastroenterol. 2006;101:2401–2409.CrossRefPubMed
9.
go back to reference Locke GR 3rd, Pemberton JH, Phillips SF. American Gastroenterological Association Medical Position Statement: guidelines on constipation. Gastroenterology. 2000;119:1761–1766.CrossRefPubMed Locke GR 3rd, Pemberton JH, Phillips SF. American Gastroenterological Association Medical Position Statement: guidelines on constipation. Gastroenterology. 2000;119:1761–1766.CrossRefPubMed
10.
go back to reference Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology. Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2006;43:e1–13. Constipation Guideline Committee of the North American Society for Pediatric Gastroenterology. Evaluation and treatment of constipation in infants and children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2006;43:e1–13.
11.
go back to reference Shah ND, Chitkara DK, Locke GR, et al. Ambulatory care for constipation in the United States, 1993–2004. Am J Gastroenterol. 2008;103:1746–1753.CrossRefPubMed Shah ND, Chitkara DK, Locke GR, et al. Ambulatory care for constipation in the United States, 1993–2004. Am J Gastroenterol. 2008;103:1746–1753.CrossRefPubMed
13.
go back to reference Baker SS, Liptak GS, Colletti RB, et al. Constipation in infants and children: evaluation and treatment. A medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 1999;29:612–626.CrossRefPubMed Baker SS, Liptak GS, Colletti RB, et al. Constipation in infants and children: evaluation and treatment. A medical position statement of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 1999;29:612–626.CrossRefPubMed
Metadata
Title
Prescribing Patterns for the Outpatient Treatment of Constipation in the United States
Authors
Katy E. Trinkley
Kyle Porter
Milap C. Nahata
Publication date
01-12-2010
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 12/2010
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-010-1196-3

Other articles of this Issue 12/2010

Digestive Diseases and Sciences 12/2010 Go to the issue