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Transanal Irrigation in Children: Treatment Success, Quality of Life, Adherence, Patient Experience, and Independence.
- Source :
-
Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2022 Aug 01; Vol. 75 (2), pp. 166-172. Date of Electronic Publication: 2022 Jun 07. - Publication Year :
- 2022
-
Abstract
- Objectives: To investigate the clinical effectiveness and patient experience of transanal irrigation (TAI) in children with constipation or fecal incontinence.<br />Methods: Combined retrospective and cross-sectional study including pediatric patients who used a Navina TAI system. We retrospectively collected baseline characteristics and data on treatment success at 1- and 6-month follow-up (FU). Treatment success was defined as defecating at least 3 times per week and having less than 1 episode of fecal incontinence per week. We cross-sectionally assessed health-related quality of life (HRQoL), treatment adherence, treatment satisfaction (Treatment Satisfaction Questionnaire for Medication [TSQM]), illness perceptions, medication beliefs, and patient empowerment with validated questionnaires.<br />Results: Thirty-four patients were included (median age at start TAI: 11 years old [range, 6-18]), 32 in the retrospective review, and 26 in the cross-sectional survey (median of 3 years after initiation). Most patients were diagnosed with functional constipation (n = 26; 76%) or a neurogenic bowel disorder (n = 6; 18%). Treatment success rates significantly improved at each FU compared with baseline (baseline: 4/25 [16%]; 1-month FU: 12/16 [75%], P = 0.008; 6-month FU: 11/18 [61%], P = 0.016; cross-sectional FU: 13/26 [50%], P = 0.008). HRQoL scores were high (PedsQL median, 73 [IQR, 54-85]). Adherence (defined as Medication Adherence Report Scale [MARS] ≥ 23) was low (36%), whereas TSQM effectiveness scores were high (median, 69 [IQR, 47-86]). The majority of children (61%) reported an increase in independence since TAI treatment. Patient empowerment (GYPES) levels were similar to those reported in children with other chronic conditions.<br />Conclusions: TAI with a Navina system is an effective bowel management system for children with intractable constipation or fecal incontinence.<br />Competing Interests: The authors report no conflicts of interest.<br /> (Copyright © 2022 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Details
- Language :
- English
- ISSN :
- 1536-4801
- Volume :
- 75
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of pediatric gastroenterology and nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 35675698
- Full Text :
- https://doi.org/10.1097/MPG.0000000000003515