Treatment Patterns, Perceptions, Barriers, and Costs in Patients With Chronic Idiopathic Constipation in the United States

TL;DR

This study explores treatment patterns, barriers, and costs for chronic idiopathic constipation in the U.S., highlighting patient and healthcare provider perspectives.

Contribution

The study provides real-world insights into CIC treatment preferences, barriers, and financial impact from both patient and HCP perspectives.

Findings

Most healthcare providers prioritize lifestyle changes and OTC treatments before prescription medications.

Patients value symptom relief and affordability more than long-term efficacy.

High costs of HCP visits and medication co-payments may limit patient access to CIC therapies.

Abstract

Limited real-world data are available on barriers to prescribing or recommending treatments for chronic idiopathic constipation (CIC), treatment experiences and expectations, and the financial impact of CIC from the perspectives of patients and health-care professionals (HCPs).

In this noninterventional, cross-sectional, retrospective survey in the United States (October 2022–June 2023), board-certified gastroenterologists, motility specialists, advanced practice providers, and primary care physicians each recruited up to 8 adults with HCP-diagnosed CIC and no previous CIC clinical trial enrollment. HCP and patient surveys, and case report forms (CRFs) captured demographics and treatment patterns, perceptions, barriers, and costs.

Overall, 170 HCPs completed CRFs for 368 patients, of whom 230 completed the patient survey. Mean (standard deviation) patient age was 50.2 (16.5) years (CRF) and 49.7 (16.2) years (patient survey). HCPs would ideally recommend lifestyle/dietary modifications and over-the-counter treatments before prescription medications. Most HCPs rated increased quality of life (73.5%) and long-term efficacy (71.2%) as important when managing CIC, whereas most patients considered symptom relief (83.8%) and affordability (80.7%) as important. HCPs did not report substantial barriers to prescribing treatments, whereas patients reported difficulty getting an HCP appointment (36.3%) and a lack of awareness of CIC prescription medications (34.8%). Most HCPs and patients were satisfied with treatment options. The greatest patient expenses (30-day mean costs [$]) were seeing an HCP ($30.3) and prescription medication co-payments ($28.4).

Despite most patients feeling satisfied with CIC treatment options, education on the availability of prescription medication in the United States is needed. This limited awareness, the patient expense of HCP visits, and prescription medication co-payments may limit patient access to CIC therapies.

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