Does primary care physicians use macrogols as the first-line treatment for functional constipation in pediatric population in central European country?

Introduction
There is little data on the treatment of functional constipation (FC) among pediatric population in Europe. We aimed to evaluate how often Polish primary care physicians (i.e., pediatricians, general practitioners [GPs], and pediatric gastroenterologists) prescribe polyethylene glycol as a treatment of FC. Also, we assessed the impact of educational materials received by parents on the compliance management of FC.

Material and methods
This was a was prospective, multicenter study. A self-developed questionnaire was distributed among Polish doctors, who treat children with FC; they were asked to completed it twice with patients and their caregivers. Questions were on the treatment of constipation, which the parents used before visiting the doctor and treatment used by the doctor as well as their impression on received educational materials. The study was approved by the Ethics Committee of Warsaw Medical University (AKBE/269/2024).

Results
In total, 1,358 children, aged 6 months – 12 years (median: 5 years; boys: 56.1%), were included in the study. We received 688 questionnaires from pediatricians, 270 from GPs, and 400 from pediatric gastroenterologists. Polyethylene glycol was the most prescribed medication by the doctors (84.4% of children). Pediatric gastroenterologists used macrogols less often than pediatricians and GPs (78.5%, 85.3%, and 90.7%, respectively; p = 0.000). In the second survey, nine out of ten patients declared complying with recommendations from previous visit. Educational materials were most frequently rated as useful (66.2%), understandable (53.2%), and helpful (49.5%).

Conclusions
Pediatric gastroenterologists use macrogols less often than pediatricians and GPs. Education materials help majority of patients to understand the pathophysiology of FC, which can be the key factor helping maintaining appropriate therapy between visits.