title: Treatment Algorithm for Chronic Idiopathic Constipation and Constipation-Predominant Irritable Bowel Syndrome Derived from a Canadian National Survey and Needs Assessment on Choices of Therapeutic Agents.
abstract: Background. Chronic idiopathic constipation (CIC) and constipation-predominant irritable bowel syndrome (IBS-C) are common functional lower gastrointestinal disorders that impair patients' quality of life. In a national survey, we aimed to evaluate (1) Canadian physician practice patterns in the utilization of therapeutic agents listed in the new ACG and AGA guidelines; (2) physicians satisfaction with these agents for their CIC and IBS-C patients; and (3) the usefulness of these new guidelines in their clinical practice.Methods. A 9-item questionnaire was sent to 350 Canadian specialists to evaluate their clinical practice for the management of CIC and IBS-C.Results. The response rate to the survey was 16% (n= 55). Almost all (96%) respondents followed a standard, stepwise approach for management while they believed that only 24% of referring physicians followed the same approach. Respondents found guanylyl cyclase C (GCC) agonist most satisfying when treating their patients. Among the 69% of respondents who were aware of published guidelines, only 50% found them helpful in prioritizing treatment choices and 69% of respondents indicated that a treatment algorithm, applicable to Canadian practice, would be valuable.Conclusion. Based on this needs assessment, a treatment algorithm was developed to provide clinical guidance in the management of IBS-C and CIC in Canada.
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Tse
authors.affiliation: McMaster University, Hamilton, ON, Canada.
authors.forename: David
authors.identifier: 0000-0003-2487-1479
authors.initials: D
authors.lastname: Armstrong
authors.affiliation: University of Calgary, Calgary, AB, Canada.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Andrews
authors.affiliation: McGill University, Montreal, QC, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Bitton
authors.affiliation: University of British Columbia, Vancouver, BC, Canada.
authors.forename: Brian
authors.identifier: 0000-0003-4740-8209
authors.initials: B
authors.lastname: Bressler
authors.affiliation: McMaster University, Hamilton, ON, Canada.
authors.forename: John
authors.identifier: 0000-0002-0523-9032
authors.initials: J
authors.lastname: Marshall
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Louis W C
authors.identifier: 0000-0001-6899-7941
authors.initials: LW
authors.lastname: Liu
mesh_terms: D000465:Algorithms; D001572:Benzofurans / Q000627:therapeutic use; D002170:Canada; D002908:Chronic Disease; D003248:Constipation / Q000188:drug therapy*; D004043:Dietary Fiber / Q000627:therapeutic use*; D019587:Dietary Supplements; D019468:Disease Management; D000072102:Gastroenterologists; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy*; D054368:Laxatives / Q000627:therapeutic use*; D020380:Needs Assessment; D010455:Peptides / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000074261:Receptors, Enterotoxin; D050705:Receptors, Guanylate Cyclase-Coupled / Q000819:agonists; D018000:Receptors, Peptide / Q000819:agonists; D058828:Serotonin 5-HT4 Receptor Agonists / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D001572:Benzofurans; D004043:Dietary Fiber; D005765:Gastrointestinal Agents; D054368:Laxatives; D010455:Peptides; D018000:Receptors, Peptide; D058828:Serotonin 5-HT4 Receptor Agonists; C406662:prucalopride; D000074261:Receptors, Enterotoxin; D050705:Receptors, Guanylate Cyclase-Coupled; C523483:linaclotide