Prescribing patterns for the outpatient treatment of constipation in the United States.

BACKGROUND: The incidence of constipation is rising. National data on the prescribing of pharmacologic and nonpharmacologic therapies, or factors influencing the prescribing of therapies for constipation are limited. AIMS: This study was designed to (1) identify prescribing patterns for constipation, and (2) determine associations between prescribing patterns and demographic variables among US outpatients.
METHODS: This was a retrospective cross-sectional study utilizing data from the National Ambulatory Medical Care Survey (NAMCS) from 1997 to 2006 on constipation treatment trends across different age groups. Information collected from each visit included demographic data, pharmacologic and nonpharmacologic therapies for constipation. To assess for trends, the data for 1997-2001 and 2002-2006 were compared.
RESULTS: A total of 52.7 million patient visits were related to constipation. Treatments prescribed were medication and nonpharmacologic therapies for 17% of visits, medications for 21%, nonpharmacologic therapies for 23%, and no therapy for 39%. From 1997-2001 to 2002-2006, the prescribing of medications increased 12% and nonpharmacologic therapies decreased 6%; hyperosmolars increased 15% and saline laxatives decreased 3%. Within the age groups, factors associated with prescribing included gender, ethnicity, race, physician specialty, and region.
CONCLUSIONS: Prescribing of medications increasingly replaced nonpharmacologic therapies. Hyperosmolars were prescribed most frequently and increased over time.