The Burden and Treatment of Chronic Constipation Among US Nursing Home Residents.
Tingting Zhang, Andrew R Zullo, Hannah O James and 3 others
PMID 37308090WHAT IT FOUND
Chronic constipation is highly prevalent in US nursing homes, affecting 71.8% of residents in electronic health records and 37.5% in Medicare claims.
Treatment relies heavily on over-the-counter laxatives, while newer prescription options are rarely used despite significant associated costs.
Key findings
01The composite definition classified 25,739 or 71.8% of the EHR cohort with prevalent chronic constipation.
02In the Medicare cohort, the composite definition classified 245,578 or 37.5% with prevalent chronic constipation.
03Among residents with chronic constipation in the EHR cohort, 86.0% received a drug for treatment of constipation during the observation period.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study may have underestimated prevalence by focusing on routine drug use, potentially missing undertreated constipation. Data for residents enrolled in Medicare Advantage plans were unavailable, limiting applicability to that population. The study design cannot determine causal relationships between chronic constipation and hospitalizations. EHR data came from a single for-profit corporation, which may limit generalizability to other nursing home settings. The EHR cohort had only 1 year of data, restricting follow-up duration compared to the Medicare cohort.
Declared interests
The study was supported by the National Institute on Aging of the National Institutes of Health and the Department of Health and Human Services. No specific conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume the 71.8% prevalence in the EHR cohort reflects the true rate in all nursing homes. This figure is much higher than the 37.5% found in Medicare claims, likely because EHR data captures over-the-counter laxative use that Medicare Part D does not cover.