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Opioid-Induced Constipation among a Convenience Sample of Patients with Cancer Pain

BACKGROUND: Little is known regarding the burden of opioid-induced constipation (OIC) among patients who suffer from cancer-related pain. METHODS: A prospective longitudinal study was conducted among cancer patients in the United Kingdom (UK), Canada, and Germany, which included medical record data...

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Autores principales: Coyne, Karin S., Sexton, Chris, LoCasale, Robert J., King, Frederic R., Margolis, Mary Kay, Ahmedzai, Sam H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896913/
https://www.ncbi.nlm.nih.gov/pubmed/27376025
http://dx.doi.org/10.3389/fonc.2016.00131
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author Coyne, Karin S.
Sexton, Chris
LoCasale, Robert J.
King, Frederic R.
Margolis, Mary Kay
Ahmedzai, Sam H.
author_facet Coyne, Karin S.
Sexton, Chris
LoCasale, Robert J.
King, Frederic R.
Margolis, Mary Kay
Ahmedzai, Sam H.
author_sort Coyne, Karin S.
collection PubMed
description BACKGROUND: Little is known regarding the burden of opioid-induced constipation (OIC) among patients who suffer from cancer-related pain. METHODS: A prospective longitudinal study was conducted among cancer patients in the United Kingdom (UK), Canada, and Germany, which included medical record data abstraction, Internet-based patient surveys, and physician surveys. Patients on daily opioid therapy (≥30 mg for ≥4 weeks) for treatment of cancer pain with self-reported OIC were recruited. Response to laxatives was defined by classifying participants into categories of laxative use and evaluating the prevalence of inadequate response. Descriptive statistics were used to evaluate outcomes, including the patient assessment of constipation-symptom (PAC-SYM), patient assessment of constipation-quality of life, EuroQOL-5 dimensions, and global assessment of treatment benefit, satisfaction, and willingness to continue. RESULTS: Recruitment was difficult for this study with only 31 participants completing the baseline survey and meeting criteria for opioid use and OIC (26 UK, 1 Canada, and 4 Germany). Fifty-two percent (n = 16) of participants were male, and all were White. Breast (23%, n = 7), pancreatic (13%, n = 4), and multiple myeloma (13%, n = 4) were the most common cancers. Mean duration of chronic pain and opioid use were 2.3 and 1.3 years, respectively. Participants reported having a mean of 4.4 bowel movements/week in the 2 weeks prior to baseline, of which a mean of 0.9 were spontaneous. Most participants (90%, n = 28) were using at least 1 lifestyle approach to manage their constipation; 65% (n = 20) were taking ≥1 over-the-counter laxative; 19% (n = 6) were taking ≥1 prescription laxative; 23% (n = 7) reported no laxative use in the prior 2 weeks. Moderate-to-severe constipation symptoms on the PAC-SYM were common, and mean scores on health-related quality of life outcomes were comparable to chronic pain populations. CONCLUSION: In this primarily UK sample, there appears to be considerable unmet OIC treatment needs among cancer patients.
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spelling pubmed-48969132016-07-01 Opioid-Induced Constipation among a Convenience Sample of Patients with Cancer Pain Coyne, Karin S. Sexton, Chris LoCasale, Robert J. King, Frederic R. Margolis, Mary Kay Ahmedzai, Sam H. Front Oncol Oncology BACKGROUND: Little is known regarding the burden of opioid-induced constipation (OIC) among patients who suffer from cancer-related pain. METHODS: A prospective longitudinal study was conducted among cancer patients in the United Kingdom (UK), Canada, and Germany, which included medical record data abstraction, Internet-based patient surveys, and physician surveys. Patients on daily opioid therapy (≥30 mg for ≥4 weeks) for treatment of cancer pain with self-reported OIC were recruited. Response to laxatives was defined by classifying participants into categories of laxative use and evaluating the prevalence of inadequate response. Descriptive statistics were used to evaluate outcomes, including the patient assessment of constipation-symptom (PAC-SYM), patient assessment of constipation-quality of life, EuroQOL-5 dimensions, and global assessment of treatment benefit, satisfaction, and willingness to continue. RESULTS: Recruitment was difficult for this study with only 31 participants completing the baseline survey and meeting criteria for opioid use and OIC (26 UK, 1 Canada, and 4 Germany). Fifty-two percent (n = 16) of participants were male, and all were White. Breast (23%, n = 7), pancreatic (13%, n = 4), and multiple myeloma (13%, n = 4) were the most common cancers. Mean duration of chronic pain and opioid use were 2.3 and 1.3 years, respectively. Participants reported having a mean of 4.4 bowel movements/week in the 2 weeks prior to baseline, of which a mean of 0.9 were spontaneous. Most participants (90%, n = 28) were using at least 1 lifestyle approach to manage their constipation; 65% (n = 20) were taking ≥1 over-the-counter laxative; 19% (n = 6) were taking ≥1 prescription laxative; 23% (n = 7) reported no laxative use in the prior 2 weeks. Moderate-to-severe constipation symptoms on the PAC-SYM were common, and mean scores on health-related quality of life outcomes were comparable to chronic pain populations. CONCLUSION: In this primarily UK sample, there appears to be considerable unmet OIC treatment needs among cancer patients. Frontiers Media S.A. 2016-06-08 /pmc/articles/PMC4896913/ /pubmed/27376025 http://dx.doi.org/10.3389/fonc.2016.00131 Text en Copyright © 2016 Coyne, Sexton, LoCasale, King, Margolis and Ahmedzai. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Coyne, Karin S.
Sexton, Chris
LoCasale, Robert J.
King, Frederic R.
Margolis, Mary Kay
Ahmedzai, Sam H.
Opioid-Induced Constipation among a Convenience Sample of Patients with Cancer Pain
title Opioid-Induced Constipation among a Convenience Sample of Patients with Cancer Pain
title_full Opioid-Induced Constipation among a Convenience Sample of Patients with Cancer Pain
title_fullStr Opioid-Induced Constipation among a Convenience Sample of Patients with Cancer Pain
title_full_unstemmed Opioid-Induced Constipation among a Convenience Sample of Patients with Cancer Pain
title_short Opioid-Induced Constipation among a Convenience Sample of Patients with Cancer Pain
title_sort opioid-induced constipation among a convenience sample of patients with cancer pain
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896913/
https://www.ncbi.nlm.nih.gov/pubmed/27376025
http://dx.doi.org/10.3389/fonc.2016.00131
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