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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.
PMID
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Authors

Mayor MeshTerms

Algorithms

Keywords
Journal Title canadian journal of gastroenterology & hepatology
Publication Year Start




PMID- 28271055
OWN - NLM
STAT- MEDLINE
DA  - 20170308
DCOM- 20170314
LR  - 20170314
IS  - 2291-2797 (Electronic)
IS  - 2291-2789 (Linking)
VI  - 2017
DP  - 2017
TI  - 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.
PG  - 8612189
LID - 10.1155/2017/8612189 [doi]
AB  - 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.
FAU - Tse, Yvonne
AU  - Tse Y
AD  - University of Toronto, Toronto, ON, Canada.
FAU - Armstrong, David
AU  - Armstrong D
AUID- ORCID: 0000-0003-2487-1479
AD  - McMaster University, Hamilton, ON, Canada.
FAU - Andrews, Christopher N
AU  - Andrews CN
AD  - University of Calgary, Calgary, AB, Canada.
FAU - Bitton, Alain
AU  - Bitton A
AD  - McGill University, Montreal, QC, Canada.
FAU - Bressler, Brian
AU  - Bressler B
AUID- ORCID: 0000-0003-4740-8209
AD  - University of British Columbia, Vancouver, BC, Canada.
FAU - Marshall, John
AU  - Marshall J
AUID- ORCID: 0000-0002-0523-9032
AD  - McMaster University, Hamilton, ON, Canada.
FAU - Liu, Louis W C
AU  - Liu LW
AUID- ORCID: 0000-0001-6899-7941
AD  - University of Toronto, Toronto, ON, Canada.
LA  - eng
PT  - Journal Article
DEP - 20170208
PL  - Egypt
TA  - Can J Gastroenterol Hepatol
JT  - Canadian journal of gastroenterology & hepatology
JID - 101623613
RN  - 0 (Benzofurans)
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Laxatives)
RN  - 0 (Peptides)
RN  - 0 (Receptors, Peptide)
RN  - 0 (Serotonin 5-HT4 Receptor Agonists)
RN  - 0 (linaclotide)
RN  - 0A09IUW5TP (prucalopride)
RN  - EC 4.6.1.2 (Receptors, Guanylate Cyclase-Coupled)
RN  - EC 4.6.1.2 (enterotoxin receptor)
SB  - IM
MH  - *Algorithms
MH  - Benzofurans/therapeutic use
MH  - Canada
MH  - Chronic Disease
MH  - Constipation/*drug therapy
MH  - Dietary Fiber/*therapeutic use
MH  - Dietary Supplements
MH  - Disease Management
MH  - Gastroenterologists
MH  - Gastrointestinal Agents/*therapeutic use
MH  - Humans
MH  - Irritable Bowel Syndrome/*drug therapy
MH  - Laxatives/*therapeutic use
MH  - Needs Assessment
MH  - Peptides/therapeutic use
MH  - Practice Guidelines as Topic
MH  - Practice Patterns, Physicians'/*statistics & numerical data
MH  - Receptors, Guanylate Cyclase-Coupled/agonists
MH  - Receptors, Peptide/agonists
MH  - Serotonin 5-HT4 Receptor Agonists/*therapeutic use
MH  - Surveys and Questionnaires
PMC - PMC5320366
COI - Dr. Yvonne Tse has received honorarium for participation in advisory boards from 
      AbbVie. Dr. David Armstrong has received research funding from AbbVie; honoraria 
      for participation in advisory boards and/or speaking at educational events from
      AbbVie, Allergan, Cubist, Ferring, Hospira, Janssen, Lupin, Pendopharm, Pentax,
      Pfizer, Shire, and Takeda; sponsorship for educational events from AbbVie,
      Allergan, Boston Scientific, Cook Medical, Ferring, Hospira, Janssen, Lupin,
      Olympus, Pendopharm, Shire, and Takeda. Dr. Christopher Andrews has received
      research funding from Janssen and Allergan and honoraria from Allergan,
      Pendopharm, Lupin, and AbbVie. Dr. Alain Bitton has received honorarium for
      participation in advisory boards from Allergan. Dr. Brian Bressler has received
      research funding from AbbVie, Amgen, Takeda, BMS, Genentech, Janssen, BI, GSK,
      Redhill Biopharm, Celgene, and Merck; honoraria for participation in advisory
      boards and/or speaking at educational events from AbbVie, Janssen, Takeda, Shire,
      Pendopharm, Ferring, Pfizer, Amgen, and Merck; honoraria for providing consulting
      service from Genentech, Pendopharm, and Allergan. Dr. John Marshall has received 
      honoraria for participation in speaking at educational events from AbbVie,
      Allergan, Ferring, Janssen, Procter & Gamble, Shire, and Takeda and honoraria for
      providing consulting service from AbbVie, Allergan, Astra-Zeneca,
      Boehringer-Ingelheim, Celgene, Celltrion, Ferring, Hospira, Janssen, Merck,
      Pfizer, Pharmascience, Procter & Gamble, Shire, and Takeda. Dr. Louis Liu has
      received honoraria for participation in advisory boards and/or speaking at
      educational events from Takeda, AbbVie, Allergan, and Lupin and honorarium for
      providing consulting service from Allergan.
EDAT- 2017/03/09 06:00
MHDA- 2017/03/16 06:00
CRDT- 2017/03/09 06:00
PHST- 2016/07/28 [received]
PHST- 2016/11/23 [revised]
PHST- 2016/12/18 [accepted]
AID - 10.1155/2017/8612189 [doi]
PST - ppublish
SO  - Can J Gastroenterol Hepatol. 2017;2017:8612189. doi: 10.1155/2017/8612189. Epub
      2017 Feb 8.

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