Dinesh S. Pashankar
Associate Professor of Pediatrics Director, Pediatric IBD Program, Yale University School of Medicine, USA
Title: Improving care of children with digestive diseases: Research and Quality Improvement
Biography
Biography: Dinesh S. Pashankar
Abstract
Statement of the Problem: Healthcare outcomes can be improved by innovative research by with novel safe and effective medications or by using quality improvement tools and same medical therapy. Our group has been active in both research and quality improvement methods to improve care of children with digestive diseases. Constipation and inflammatory bowel disease are two common digestive disorders in children. Both are chronic disorders and constipation is a common and problem worldwide while IBD is more common in developed world. Research studies - In the past, treatment of constipation in children was difficult due to poor acceptance of laxatives by children. Our group performed first study of a novel compound polyethylene glycol 3350 in the treatment of constipation in children. We reported safety, efficacy, and high acceptance of polyethylene glycol in children. We also described novel indications of polyethylene glycol for use in bowel preparation for colonoscopy in children. We demonstrated superior efficacy of polyethylene glycol compared with milk of magnesia. As a result of our and other studies, polyethylene glycol has been recommended as a first line of therapy for constipation in children. Quality Improvement – In our IBD program, we use innovative quality improvement tools along with same medical therapy and have improved outcomes in our patients with IBD. Our remission rates (lack of gastrointestinal and general symptoms) are higher than target rates for 5 years. We have also been successful at maintaining above average nutritional and growth status of our patients. Conclusion & Significance: Our studies show that polyethylene glycol has been a very effective and safe therapy and has become a gamechanger laxative in the treatment of constipation in children worldwide. Using quality improvement tools, we demonstrate high remission rates in our patients with IBD. Both, innovative research and quality improvement can improve outcomes and care of children in clinical practice.