Michael R. Brodeur, PharmD, CGP, FASCP
Department of Pharmacy Practice
Albany College of Pharmacy
Brooks D. Cash, MD, FACP, FACG
Associate Professor of Medicine
National Naval Medical Center
Division of Gastroenterology
Interactive Virtual Clinic
Chronic constipation is highly prevalent in older individuals. Those residing in long-term care facilities may be especially prone, due to additional chronic disease burdens, immobility, and/or functional limitations. The etiology of chronic constipation varies tremendously, ranging from metabolic disorders to side effects of common drugs. Chronic constipation must be differentiated from other forms of constipation, and secondary causes, since the management principles vary.
The management of chronic constipation involves a combination of patient education, dietary or pharmacologic modifications, and the judicious use of laxatives, enemas, and other pharmacotherapies. Without proper treatment, severe constipation may develop and can lead to or exacerbate medical problems, such as stercoral ulcers, hemorrhoids, anal fissures, and megacolon, which may lead to bowel perforation. Fecal impaction is another serious concern, especially in nursing homes, because it is considered a Quality Indicator (QI). Fecal impaction, combined with the presence of dehydration and pressure ulcers, is a serious and undesirable outcome that must be avoided.
By providing caregivers with continuing education focused on safe and effective evidence-based treatment strategies to optimally manage chronic constipation, more serious complications may be prevented. Continuing education can also help clinicians be prepared with proper management strategies and treatment plans to implement when serious complications from chronic constipation occur in geriatric patients.
. Target Audience
Medical directors, other physicians, nurses, and pharmacists caring for older adults
Upon completion of this educational activity, the participant should be able to:
Discuss the groups of patients with constipation who are at risk for severe complications.
Identify serious conditions that may present as a consequence of chronic constipation and adverse events that may occur from constipation therapy.
Describe ways to tailor management strategies and treatment plans for elderly patients with chronic constipation in order to prevent or treat severe complications.
It is the policy of ASCP, in accordance with the guidelines set forth by the Accreditation Council for Pharmacy Education, and AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflict of interest is resolved by ASCP and AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.
Dr. Michael R. Brodeur has no conflicts to disclose.
Dr. Brooks D. Cash discloses his participation on the speakers' bureau for Salix Pharmaceuticals, Inc., Takeda Pharmaceuticals North America, Inc., Sucampo Pharmaceuticals, Inc., and Prometheus and his serving as a consultant to Salix Pharmaceuticals, Inc., Takeda Pharmaceuticals North America, Inc., and Prometheus.
This educational activity may contain discussion of published and/or investigational uses of pharmaceutical agents. Some uses of these agents may not have been approved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Credit Statements
PHYSICIANS: This activity has been planned and implemented in accordance with the Essential Areas and polices of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of AKH Inc. and Medical Communications Media, Incorporated. AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians.
AKH Inc. designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
NURSES: AKH Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC-COA).
AKH Inc. designates this educational activity for 1.0 contact hour (0.1 CEU). Accreditation applies solely to educational activities and does not imply approval or endorsement of any commercial product by the ANCC-COA.
PHARMACISTS:The American Society of Consultant Pharmacists (ASCP) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program (ACPE # 203-999-09-003-H01-P) was developed by ASCP and is approved for 1.0 Contact Hour (0.1 CEU).
This activity should take approximately 60 minutes to complete. To receive credit, participants must successfully complete the post-test.
Credit will be awarded for a score of 70% or better, and a certificate/statement may be printed immediately after passing the post-test. One retake is permitted.
Commercial Support Statements
Supported by an educational grant from Sucampo Pharmaceuticals, Inc. and Takeda Pharmaceuticals North America, Inc.
None of the contents of this activity may be reproduced in any form without prior written permission of the publisher. The opinions expressed in this activity are those of the speakers and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, AKH Inc., Sucampo Pharmaceuticals, Inc., or Takeda Pharmaceuticals North America, Inc. Any medications, or other diagnostic or treatment procedures discussed by the program speakers should not be utilized by clinicians without evaluation of their patients’ conditions and of possible contraindications or risks, and without a review of any applicable manufacturer’s product information and comparison with the recommendations of other authorities.