{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:22:51Z","timestamp":1755796971974,"version":"3.44.0"},"reference-count":31,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec id=\"S2056472425108144_as1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Constipation is a significant problem for people with intellectual disabilities, with a prevalence of 33\u201350%, causing at least five deaths annually in England. Individualised bowel care plans (IBCP) are recommended in England and Wales.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108144_as2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>We evaluated the feasibility and impact of IBCPs for people with intellectual disabilities who are in in-patient psychiatric units, and the effect on clinical outcomes.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108144_as3\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>People with intellectual disabilities who were at risk of constipation were recruited from four specialist in-patient psychiatric units in England and Wales. A constipation questionnaire was used to capture relevant data to devise IBCPs. Baseline, 3- and 6-monthly Health of the Nation Scales \u2013 Learning Disability (HoNOS-LD) were completed after the intervention. Descriptive statistics, Wilcoxon signed-rank, Mann-Whitney <jats:italic>U<\/jats:italic>, repeated-measures analyses of variance, with Bonferroni adjustment and Mauchly\u2019s tests were conducted. Significance was taken at <jats:italic>P<\/jats:italic> &lt; 0.05.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108144_as4\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Of 24 people with intellectual disabilities recruited from four units, all three data points were available for 18 patients. Constipation rates showed no statistically significant decline. The total HoNOS-LD score (18 items) did not decline. HoNOS-LD item 12 for physical functioning showed significant improvement for PwID with constipation compared with those without, between baseline and 6 months.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108144_as5\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>This quality improvement project suggests that a bigger study of IBCPs is feasible. Most outcomes examined via the HoNOS-LD, particularly those linked with mental illness, challenging behaviour and quality of life, did not show significant change, possibly because of the small sample size. However, people with intellectual disabilities and constipation showed positive changes in their physical functioning outcomes compared with those without constipation. Further in-depth evaluation of this intervention is needed.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10814","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T10:28:59Z","timestamp":1755512939000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Using individualised bowel care plans to improve clinical outcomes in specialist intellectual disability mental health units in England and Wales: quality improvement project"],"prefix":"10.1192","volume":"11","author":[{"given":"Alexandra","family":"Gabrielsson","sequence":"first","affiliation":[{"name":"Hertfordshire Partnership University NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9916-343X","authenticated-orcid":false,"given":"Richard","family":"Laugharne","sequence":"additional","affiliation":[{"name":"Cornwall Partnership NHS Foundation Trust"},{"name":"University of Plymouth"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1589-4054","authenticated-orcid":false,"given":"Jon","family":"Painter","sequence":"additional","affiliation":[{"name":"Sheffield Hallam University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harriet","family":"Slater","sequence":"additional","affiliation":[{"name":"Aneurin Bevan University Health Board"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Bright","sequence":"additional","affiliation":[{"name":"Aneurin Bevan University Health Board"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Dossett","sequence":"additional","affiliation":[{"name":"Sussex Partnership NHS Foundation Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romanie","family":"Dekker","sequence":"additional","affiliation":[{"name":"Mildmay 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Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0714-6048","authenticated-orcid":false,"given":"Kiran","family":"Purandare","sequence":"additional","affiliation":[{"name":"Central and Northwest London Foundation NHS Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1183-6933","authenticated-orcid":false,"given":"Rohit","family":"Shankar","sequence":"additional","affiliation":[{"name":"Cornwall Partnership NHS Foundation Trust"},{"name":"University of Plymouth"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"S2056472425108144_ref15","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2024.50"},{"key":"S2056472425108144_ref22","first-page":"284","article-title":"Engaging patients in decision-making and behavior change to promote 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Poo Matters \u2013 Information for Families and Carers. NHS England, 2019 (https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2019\/05\/constipation-resources-families-carers-stage-31-web.pdf)."},{"key":"S2056472425108144_ref6","first-page":"S5","article-title":"Systematic review on the management of chronic constipation in North America","volume":"100","author":"Brandt","year":"2005","journal-title":"Am J Gastroenterol"},{"key":"S2056472425108144_ref12","unstructured":"12 NHS England. Learning from Lives and Deaths \u2013 People with a Learning Disability and Autistic People (LeDeR) Policy, 2021. NHS England, 2021 (https:\/\/www.england.nhs.uk\/publication\/learning-from-lives-and-deaths-people-with-a-learning-disability-and-autistic-people-leder-policy-2021\/)."},{"key":"S2056472425108144_ref28","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-021-00859-0"},{"key":"S2056472425108144_ref5","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2024.0056"},{"key":"S2056472425108144_ref16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04273.x"},{"key":"S2056472425108144_ref27","unstructured":"27 King, R , Rabino, S. ACB Calculator, 2023 (https:\/\/www.acbcalc.com\/)."},{"key":"S2056472425108144_ref2","doi-asserted-by":"publisher","DOI":"10.1258\/1355819054338997"},{"key":"S2056472425108144_ref23","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2024.12"},{"key":"S2056472425108144_ref13","unstructured":"13 NHS England and NHS Improvement. 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e186"}}