Development and evaluation of an interdisciplinary group intervention for pediatric functional constipation.

Abstract

Objective: A group behavioral treatment protocol for pediatric encopresis was last described before significant medical advances have changed medical guidelines for constipation treatment, although no updated behavioral treatment protocols have been published. The current study aims to describe an updated interdisciplinary group treatment protocol for pediatric functional constipation and encopresis and evaluate this for feasibility and acceptability. Method: The development and protocol of the Functional Constipation Shared Medical Appointment (FC-SMA) is described in detail. Patients recruited for the initial 24 months of the integrated group treatment program were described and evaluated for protocol feasibility, acceptability, and initial treatment outcomes, utilizing attendance records, a standardized patient satisfaction questionnaire (PSQ), and treatment outcomes recorded in medical records, respectively. Results: Forty-9 patients enrolled in the FC-SMA, with 43 (87.8%) completing the initial 4-sesion protocol and 34 (69.4%) returning for at least 1 follow-up session. Parent satisfaction was high (PSQ M(SD) ranged from 4.41 (.56) to 4.56 (.50)). Initial treatment outcomes demonstrated improvement or resolution of constipation and encopresis in 83.7% and 67.4% of participants, respectively. Conclusions: An interdisciplinary group treatment model for pediatric functional constipation is feasible, acceptable to patients and parents, and demonstrates promising initial outcomes. Updated medical treatment recommendations require modernized complementary behavioral treatment protocols that further address the complex medical-behavioral interactions and ongoing adherence challenges associated with this population.

Systematic review of family and pediatric constipation: An overlooked piece of the puzzle

“…Bellesheim et al stated how the inclusion of a family‐centered approach for pediatric constipation patient care will improve adherence in children with autism spectrum disorder 11 . Lamparyk et al also recommended the development of new, effective treatment as informed by an increased awareness and understanding of the barriers to adherence experienced by families 21 . Similarly, Gillespie et al echoed this recommendation in their care for a multidisciplinary approach to future research studies targeting management and outcomes 15 …”

“…11 Lamparyk et al also recommended the development of new, effective treatment as informed by an increased awareness and understanding of the barriers to adherence experienced by families. 21 multidisciplinary approach to future research studies targeting management and outcomes. 15…”

Innovations in the psychological care of pediatric disorders of gut–brain interaction.

“…Lamparyk et al (2023) discuss the evolution of parent-targeted interventions for pediatric pain-related DGBIs and provide recommendations for application to clinical practice. Strategies for obtaining physician and medical colleague support and parental engagement are offered, and logistical considerations, such as billing practices to optimize revenue, adapting practices for the child developmental stage, and effectively working with multiple parent caregivers, are addressed.…”