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

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. NICE Constipation in children and young people: audit support tool; criteria 9 and 18.

Outcome

Rates of unplanned hospital attendance for idiopathic constipation.

Data source: Hospital episode statistics from The Health and Social Care Information Centre. Child health indicator profiles including data on hospital admissions for constipation in those aged 0‑24 years are also available from Public Health England's Child and maternal health intelligence network.

What the quality statement means for service providers, healthcare professionals and commissioners

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.

What the quality statement means for patients, service users and carers

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 (NICE clinical guideline 99) recommendations 1.4.2 and 1.4.3 (key priority for implementation), 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 clinical guideline 99, Introduction]

Macrogol

A type of laxative (also called polyethylene glycol). [British National Formulary]