TY - JOUR
T1 - A multi-site retrospective case note review for clinical practices of constipation in specialist palliative care settings
AU - McIlfatrick, Sonja J
AU - Muldrew, Deborah
AU - Hasson, F.
AU - Slater, Paul F
AU - Carduff, Emma
AU - Clarke, Mike
AU - Coast, Jo
AU - Finucane, Anne
AU - Graham-Wisener, Lisa
AU - Larkin, Philip J
AU - MacArtney, John
AU - McCorry, Noleen
AU - Watson, Max
AU - Wright, Eileen
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background: Constipation is a common symptom for patients receiving palliative care. Whilst national clinical guidelines are available on the management of constipation for people with advanced cancer in specialist palliative care (SPC) settings, questions exist around clinical practice and the extent to which the guidelines are implemented in practice. This study examine current clinical practice for management of constipation for patients with advanced cancer in SPC settings.Methods: A multi-site retrospective case-note review was conducted, consisting of 150 patient case-notes from three SPC units across the United Kingdom between August 2016 and May 2017. Descriptive statistics were used to compare clinical practices to national policy guidelines for constipation.Results: A physical exam and bowel history was recorded for 109 patients (73%). Whilst the Bristol Stool Chart was used frequently across sites (96%), involvement of the multidisciplinary team varied. Almost a third of patient charts (27%) recorded no evidence of non-pharmacological management strategies. Pharmacological management was recorded frequently, with sodium docusate or senna as the preferred laxatives across all sites, however, 33% of patient charts recorded no information on the titration of laxatives. There were no consistent management strategies recorded for opioid induced constipation or bowel obstructionConclusion: Assessment and management of constipation in SPC settings is highly variable. Variations in assessment; limited use of non-pharmacological and preventative strategies, and absence of consistent strategies for opioid induced constipation or bowel obstruction are evident. Further education is needed to equip HCPs with the necessary knowledge and skills to assess and manage constipation.
AB - Background: Constipation is a common symptom for patients receiving palliative care. Whilst national clinical guidelines are available on the management of constipation for people with advanced cancer in specialist palliative care (SPC) settings, questions exist around clinical practice and the extent to which the guidelines are implemented in practice. This study examine current clinical practice for management of constipation for patients with advanced cancer in SPC settings.Methods: A multi-site retrospective case-note review was conducted, consisting of 150 patient case-notes from three SPC units across the United Kingdom between August 2016 and May 2017. Descriptive statistics were used to compare clinical practices to national policy guidelines for constipation.Results: A physical exam and bowel history was recorded for 109 patients (73%). Whilst the Bristol Stool Chart was used frequently across sites (96%), involvement of the multidisciplinary team varied. Almost a third of patient charts (27%) recorded no evidence of non-pharmacological management strategies. Pharmacological management was recorded frequently, with sodium docusate or senna as the preferred laxatives across all sites, however, 33% of patient charts recorded no information on the titration of laxatives. There were no consistent management strategies recorded for opioid induced constipation or bowel obstructionConclusion: Assessment and management of constipation in SPC settings is highly variable. Variations in assessment; limited use of non-pharmacological and preventative strategies, and absence of consistent strategies for opioid induced constipation or bowel obstruction are evident. Further education is needed to equip HCPs with the necessary knowledge and skills to assess and manage constipation.
M3 - Conference article
SN - 2045-4368
VL - 8
SP - 371
EP - 372
JO - BMJ Supportive & Palliative Care
JF - BMJ Supportive & Palliative Care
IS - 3
ER -