The impact of opioid-induced constipation among chronic pain patients with sufficient laxative use - PubMed (original) (raw)
. 2015 Dec;69(12):1448-56.
doi: 10.1111/ijcp.12718. Epub 2015 Sep 6.
Affiliations
- PMID: 26344578
- DOI: 10.1111/ijcp.12718
The impact of opioid-induced constipation among chronic pain patients with sufficient laxative use
R J LoCasale et al. Int J Clin Pract. 2015 Dec.
Abstract
Background: The impact of sufficient laxative use on opioid-induced constipation (OIC) is not known.
Aim: To understand the experience and symptom burden over time among chronic non-cancer pain patients with OIC who are sufficient laxative users.
Methods: A prospective longitudinal study was conducted in United States, Canada, Germany and UK which included medical record abstraction, patient surveys and physician surveys. Patients on daily opioid therapy for ≥ 4 weeks for chronic non-cancer pain with OIC were recruited from physician offices and completed the survey at Baseline and Weeks 2, 4, 6, 8, 12, 16, 20 and 24. Sufficient laxative use was defined as at least one laxative remedy 4 or more times in the prior 2 weeks.
Results: Of the 489 patients who completed the Baseline survey and met OIC criteria, 234 (48%) were categorised as sufficient laxative users; 65% were female; 90% were white and 75 (32%) maintained sufficient laxative use for > 7 of the 8 follow-up periods. Patient Assessment of Constipation-Symptom (PAC-SYM) and Patient Assessment of Constipation-Quality of Life (PAC-QOL) scores indicated moderate symptom severity and impact. PAC-SYM and PAC-QOL scores remained relatively unchanged over time with a maximum score change of 0.5 points. Work productivity and activity impairment remained relatively constant. Mean per cent activity impairment because of constipation was 37% at Baseline and 34% at Week 24.
Conclusions: These findings demonstrate constipation persists despite sufficient laxative use with little improvement in symptoms, HRQL or activity impairment. This ongoing burden emphasises the need to identify more efficacious constipation therapies for this chronic pain patient population.
© 2015 John Wiley & Sons Ltd.
Similar articles
- Opioid-Induced Constipation Among Patients with Chronic Noncancer Pain in the United States, Canada, Germany, and the United Kingdom: Laxative Use, Response, and Symptom Burden Over Time.
Coyne KS, Margolis MK, Yeomans K, King FR, Chavoshi S, Payne KA, LoCasale RJ. Coyne KS, et al. Pain Med. 2015 Aug;16(8):1551-65. doi: 10.1111/pme.12724. Epub 2015 Mar 20. Pain Med. 2015. PMID: 25802051 - Laxative utilization over time in chronic pain patients with opioid-induced constipation.
Datto CJ, LoCasale RJ, Margolis MK, Thompson CL, Coyne KS. Datto CJ, et al. Pain Manag. 2016 Nov;6(6):531-541. doi: 10.2217/pmt-2016-0010. Epub 2016 Aug 1. Pain Manag. 2016. PMID: 27476539 - The Burden of Opioid-Induced Constipation: Discordance Between Patient and Health Care Provider Reports.
LoCasale RJ, Datto C, Wilson H, Yeomans K, Coyne KS. LoCasale RJ, et al. J Manag Care Spec Pharm. 2016 Mar;22(3):236-45. doi: 10.18553/jmcp.2016.22.3.236. J Manag Care Spec Pharm. 2016. PMID: 27003553 Free PMC article. Clinical Trial. - Prucalopride for the treatment of women with chronic constipation in whom standard laxative regimens have failed to provide adequate relief.
Pennant M, Orlando R, Barton P, Bayliss S, Routh K, Meads C. Pennant M, et al. Health Technol Assess. 2011 May;15 Suppl 1:43-50. doi: 10.3310/hta15suppl1/05. Health Technol Assess. 2011. PMID: 21609652 Review. - Current concepts in the management of opioid-induced constipation.
Walters JB, Montagnini M. Walters JB, et al. J Opioid Manag. 2010 Nov-Dec;6(6):435-44. doi: 10.5055/jom.2010.0042. J Opioid Manag. 2010. PMID: 21269005 Review.
Cited by
- Efficacy and Safety of Peripherally Acting μ-Opioid Receptor Antagonist (PAMORAs) for the Management of Patients With Opioid-Induced Constipation: A Systematic Review.
Rekatsina M, Paladini A, Drewes AM, Ayob F, Viswanath O, Urits I, Corli O, Pergolizzi J Jr, Varrassi G. Rekatsina M, et al. Cureus. 2021 Jul 5;13(7):e16201. doi: 10.7759/cureus.16201. eCollection 2021 Jul. Cureus. 2021. PMID: 34367804 Free PMC article. Review. - Naldemedine Improves Patient-Reported Outcomes of Opioid-Induced Constipation in Patients with Chronic Non-Cancer Pain in the COMPOSE Phase 3 Studies.
Camilleri M, Hale M, Morlion B, Tack J, Webster L, Wild J. Camilleri M, et al. J Pain Res. 2021 Jul 16;14:2179-2189. doi: 10.2147/JPR.S282738. eCollection 2021. J Pain Res. 2021. PMID: 34295186 Free PMC article. - Insights into the Use of Peripherally Acting μ-Opioid Receptor Antagonists (PAMORAs) in Oncologic Patients: from Scientific Evidence to Real Clinical Practice.
Fernández-Montes A, de Velasco G, Aguín S, Farriols C, Guirado-Risueño M, Jerviz-Guía VG, Baeza-Nadal MV, Chicas-Sett R, Fírvida JL, García-Navalón F, Martín P, Perezagua-Marín C, Rodríguez D, Santamaría J, Saurí T, Cobo M. Fernández-Montes A, et al. Curr Treat Options Oncol. 2021 Feb 26;22(3):26. doi: 10.1007/s11864-021-00816-5. Curr Treat Options Oncol. 2021. PMID: 33635493 Review. - Magnesium Oxide in Constipation.
Mori H, Tack J, Suzuki H. Mori H, et al. Nutrients. 2021 Jan 28;13(2):421. doi: 10.3390/nu13020421. Nutrients. 2021. PMID: 33525523 Free PMC article. Review. - Blood-brain barrier: mechanisms governing permeability and interaction with peripherally acting μ-opioid receptor antagonists.
Viscusi ER, Viscusi AR. Viscusi ER, et al. Reg Anesth Pain Med. 2020 Sep;45(9):688-695. doi: 10.1136/rapm-2020-101403. Epub 2020 Jul 28. Reg Anesth Pain Med. 2020. PMID: 32723840 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous