Reviewer ’s report  
 
Title: Impact of guideline awareness in public pharmacies on couns eling of patients with acute 
or chronic constipation in a survey of pharmacy personnel  
 
Version: 2 Date: 17 May 2020  
 
Reviewer's report:  
 
This is a potentially interesting  paper dealing with the approach of pharmacy personnel  to  
acute and chronic constipation.  
 
Moreover it is very interesting te sting the awareness of the personnel of the guidelines and their 
attitude to change their behaviour after providing them with the applicable guideline - 
 
Background:  
 
-what is "S2K guideline"?  
 
-The authors write about a  "Step 1", a  "Step 2" and then they wr ite "All three" . It's not clear 
what's the third step..  
 
-The authors should clarify if these guidelines are conceived also  for  patients who use self -
medications or only  for HCPs . In the HCP group, are physicians included?  Unfortunately they 
are writt en in German and I am not able to understand German .  
The concept of self medication when a drug is suggested by a PH or a PTs is debatable: the 
authors should briefly discuss it. In my opinion a self medication is a drug that patients decides 
to assume au tonomously without the suggestion of a Health care professional  
 
Discussion  
 
In their discussion to compare the attitude of  Pharmacy personnel and, generally the awareness 
of guidelines and the prescription behavior and the patients'satisfaction with consti pation 
treatments  the authors could profitably use also the following papers which could allow them to 
broaden  their view outside Germany:  
 
- Sun Jung Oh at al. AJG 2020 Chronic Constipation in the United States: Results From a 
Population -Based Survey Ass essing Healthcare Seeking and Use of Pharmacotherapy  
 
-Bellini M et al. TCOL 2013,Management of chronic constipation in general practice  
 
-Bellini M. et al BMC  2017 Chronic constipation diagnosis and treatment evaluation: the 
"CHRO.CO.DI.T.E."  
study  
-Basilisco G,APT 2020 Patient dissatisfaction with medical therapy for chronic constipation or 
irritable bowel  syndrome with constipation:analysis of N -of-1 prospective trials in 81 patients  
  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following question s: 
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or sha res in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you re ceived reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interest s' 
below. If your reply is yes to any, please give details below.  
 
None  
 
Reviewer Publication Cons ent. I agree for my report to be made  available under an Open 
Access Creative Commons CC -BY License ( http://creativecommons.org/licenses/by/4.0 ) if this 
manuscript is accepted for publication. Any comments that I do not wish to be included in the 
published  report have been included as confidential comments to the editor, which will not be 
published.  If you are not happy for us to publish this report, please contact the edi torial office 
before completing the review.  If you wish, you can include your name in yo ur publish ed report. 
Please note you must decide whether to include your name at the start of the process and  confirm 
this decision whenever prompted. If you change your decision later, we will not be able to 
publish your name.  
 
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.  
(default)  
Reviewer ’s report  
 
Title: Impact of guideline awareness in public pharmacies on couns eling of patients with acute 
or chronic constipation in a survey of pharmacy personnel  
 
Version: 2 Date: 17 May 2020  
 
Reviewer's report:  
 
This is a potentially interesting  paper dealing with the approach of pharmacy personnel  to  
acute and chronic constipation.  
 
Moreover it is very interesting te sting the awareness of the personnel of the guidelines and their 
attitude to change their behaviour after providing them with the applicable guideline - 
 
Background:  
 
-what is "S2K guideline"?  
 
-The authors write about a  "Step 1", a  "Step 2" and then they wr ite "All three" . It's not clear 
what's the third step..  
 
-The authors should clarify if these guidelines are conceived also  for  patients who use self -
medications or only  for HCPs . In the HCP group, are physicians included?  Unfortunately they 
are writt en in German and I am not able to understand German .  
The concept of self medication when a drug is suggested by a PH or a PTs is debatable: the 
authors should briefly discuss it. In my opinion a self medication is a drug that patients decides 
to assume au tonomously without the suggestion of a Health care professional  
 
Discussion  
 
In their discussion to compare the attitude of  Pharmacy personnel and, generally the awareness 
of guidelines and the prescription behavior and the patients'satisfaction with consti pation 
treatments  the authors could profitably use also the following papers which could allow them to 
broaden  their view outside Germany:  
 
- Sun Jung Oh at al. AJG 2020 Chronic Constipation in the United States: Results From a 
Population -Based Survey Ass essing Healthcare Seeking and Use of Pharmacotherapy  
 
-Bellini M et al. TCOL 2013,Management of chronic constipation in general practice  
 
-Bellini M. et al BMC  2017 Chronic constipation diagnosis and treatment evaluation: the 
"CHRO.CO.DI.T.E."  
study  
-Basilisco G,APT 2020 Patient dissatisfaction with medical therapy for chronic constipation or 
irritable bowel  syndrome with constipation:analysis of N -of-1 prospective trials in 81 patients  
  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following question s: 
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or sha res in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you re ceived reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interest s' 
below. If your reply is yes to any, please give details below.  
 
None  
 
Reviewer Publication Cons ent. I agree for my report to be made  available under an Open 
Access Creative Commons CC -BY License ( http://creativecommons.org/licenses/by/4.0 ) if this 
manuscript is accepted for publication. Any comments that I do not wish to be included in the 
published  report have been included as confidential comments to the editor, which will not be 
published.  If you are not happy for us to publish this report, please contact the edi torial office 
before completing the review.  If you wish, you can include your name in yo ur publish ed report. 
Please note you must decide whether to include your name at the start of the process and  confirm 
this decision whenever prompted. If you change your decision later, we will not be able to 
publish your name.  
 
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.  
(default)  
Please review this paper.
user
Reviewer ’s report  
 
Title: Impact of guideline awareness in public pharmacies on couns eling of patients with acute 
or chronic constipation in a survey of pharmacy personnel  
 
Version: 2 Date: 17 May 2020  
 
Reviewer's report:  
 
This is a potentially interesting  paper dealing with the approach of pharmacy personnel  to  
acute and chronic constipation.  
 
Moreover it is very interesting te sting the awareness of the personnel of the guidelines and their 
attitude to change their behaviour after providing them with the applicable guideline - 
 
Background:  
 
-what is "S2K guideline"?  
 
-The authors write about a  "Step 1", a  "Step 2" and then they wr ite "All three" . It's not clear 
what's the third step..  
 
-The authors should clarify if these guidelines are conceived also  for  patients who use self -
medications or only  for HCPs . In the HCP group, are physicians included?  Unfortunately they 
are writt en in German and I am not able to understand German .  
The concept of self medication when a drug is suggested by a PH or a PTs is debatable: the 
authors should briefly discuss it. In my opinion a self medication is a drug that patients decides 
to assume au tonomously without the suggestion of a Health care professional  
 
Discussion  
 
In their discussion to compare the attitude of  Pharmacy personnel and, generally the awareness 
of guidelines and the prescription behavior and the patients'satisfaction with consti pation 
treatments  the authors could profitably use also the following papers which could allow them to 
broaden  their view outside Germany:  
 
- Sun Jung Oh at al. AJG 2020 Chronic Constipation in the United States: Results From a 
Population -Based Survey Ass essing Healthcare Seeking and Use of Pharmacotherapy  
 
-Bellini M et al. TCOL 2013,Management of chronic constipation in general practice  
 
-Bellini M. et al BMC  2017 Chronic constipation diagnosis and treatment evaluation: the 
"CHRO.CO.DI.T.E."  
study  
-Basilisco G,APT 2020 Patient dissatisfaction with medical therapy for chronic constipation or 
irritable bowel  syndrome with constipation:analysis of N -of-1 prospective trials in 81 patients  
  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following question s: 
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or sha res in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you re ceived reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interest s' 
below. If your reply is yes to any, please give details below.  
 
None  
 
Reviewer Publication Cons ent. I agree for my report to be made  available under an Open 
Access Creative Commons CC -BY License ( http://creativecommons.org/licenses/by/4.0 ) if this 
manuscript is accepted for publication. Any comments that I do not wish to be included in the 
published  report have been included as confidential comments to the editor, which will not be 
published.  If you are not happy for us to publish this report, please contact the edi torial office 
before completing the review.  If you wish, you can include your name in yo ur publish ed report. 
Please note you must decide whether to include your name at the start of the process and  confirm 
this decision whenever prompted. If you change your decision later, we will not be able to 
publish your name.  
 
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.  
(default)  
assistant