Quality standard
Quality statement 2: First-line treatment with laxatives
Quality statement 2: First-line treatment with laxatives
Quality statement
Children and young people with idiopathic constipation receive oral macrogols as first-line treatment.
Rationale
Laxatives are an effective treatment for constipation; oral macrogols are the first-line laxative of choice unless otherwise indicated. Oral macrogols are easily administered at home and in the community, and may avoid the need for invasive hospital treatment.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that children and young people with idiopathic constipation receive oral macrogols as first-line treatment.
Data source: Local data collection.
Process
Proportion of diagnosed cases of idiopathic constipation in children and young people for which oral macrogols are prescribed as first‑line treatment.
Numerator – the number in the denominator for which oral macrogols are prescribed as first‑line treatment.
Denominator – the number of diagnosed cases of idiopathic constipation in children and young people.
Data source: Local data collection.
Outcome
Rates of unplanned hospital attendance for idiopathic constipation.
Data source: Hospital Admitted Patient Care Activity from NHS Digital.
What the quality statement means for different audiences
Service providers ensure that staff prescribe oral macrogols as first-line treatment for children and young people with newly diagnosed idiopathic constipation and that oral macrogols are included on prescribers' lists.
Healthcare professionals prescribe oral macrogols as first-line treatment for children and young people with newly diagnosed idiopathic constipation.
Commissioners ensure that they commission services from providers that can demonstrate that staff prescribe oral macrogols as first-line treatment for children and young people with newly diagnosed idiopathic constipation.
Children and young people with constipation receive a medicine called a laxative to mix with water and drink as their first treatment.
Source guidance
Constipation in children and young people: diagnosis and management. NICE guideline CG99 (2010, updated 2017), recommendations 1.4.2 to 1.4.4 and 1.4.11
Definitions of terms used in this quality statement
Idiopathic constipation
Constipation that cannot (currently) be explained by any anatomical, physiological, radiological or histological abnormalities. [NICE's guideline on constipation in children and young people, Introduction]
Macrogol
A type of laxative (also called polyethylene glycol). [British National Formulary]