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Diagnostic Performance of Self-Assessment for Constipation in Patients With Long-Term Opioid Treatment

Constipation is a prevalent comorbidity affecting ∼50% of patients with long-term opioid therapy. In clinical routine different diagnostic instruments are in use to identify patients under risk. The aim of this study was to assess the diagnostic performance of an 11-item Likert scale for constipatio...

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Autores principales: Tafelski, Sascha, Bellin, Felicitas, Denke, Claudia, Beutlhauser, Torsten, Fritzsche, Thomas, West, Christina, Schäfer, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058907/
https://www.ncbi.nlm.nih.gov/pubmed/26683935
http://dx.doi.org/10.1097/MD.0000000000002227
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author Tafelski, Sascha
Bellin, Felicitas
Denke, Claudia
Beutlhauser, Torsten
Fritzsche, Thomas
West, Christina
Schäfer, Michael
author_facet Tafelski, Sascha
Bellin, Felicitas
Denke, Claudia
Beutlhauser, Torsten
Fritzsche, Thomas
West, Christina
Schäfer, Michael
author_sort Tafelski, Sascha
collection PubMed
description Constipation is a prevalent comorbidity affecting ∼50% of patients with long-term opioid therapy. In clinical routine different diagnostic instruments are in use to identify patients under risk. The aim of this study was to assess the diagnostic performance of an 11-item Likert scale for constipation used as a self-assessment in opioid-treated patients. This trial was conducted as a retrospective cohort study in Berlin, Germany. Patients with long-term opioid therapy treated in 2 university-affiliated outpatient pain facilities at the Charité hospital were included from January 2013 to August 2013. Constipation was rated in a self-assessment using a numeric rating scale from 0 to 10 (Con-NRS) and compared with results from a structured assessment based on ROME-III criteria. Altogether, 171 patients were included. Incidence of constipation was 49% of patients. The receiver-operating characteristic of Con-NRS achieved an area under the curve of 0.814 (AUC 95% confidence interval 0.748–0.880, P < 0.001). Con-NRS ≥ 1 achieved sensitivity and specificity of 79.7% and 77.2%, respectively. The positive predictive value and the negative predictive value were 70.3% and 81.6%, respectively. Overall diagnostic performance of a concise 11-item Likert scale for constipation was moderate. Although patients with long-term opioid therapy are familiar with numeric rating scales, a significant number of patients with constipation were not identified. The instrument may be additionally useful to facilitate individualized therapeutic decision making and to control therapeutic success when measured repetitively.
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spelling pubmed-50589072016-11-01 Diagnostic Performance of Self-Assessment for Constipation in Patients With Long-Term Opioid Treatment Tafelski, Sascha Bellin, Felicitas Denke, Claudia Beutlhauser, Torsten Fritzsche, Thomas West, Christina Schäfer, Michael Medicine (Baltimore) 3300 Constipation is a prevalent comorbidity affecting ∼50% of patients with long-term opioid therapy. In clinical routine different diagnostic instruments are in use to identify patients under risk. The aim of this study was to assess the diagnostic performance of an 11-item Likert scale for constipation used as a self-assessment in opioid-treated patients. This trial was conducted as a retrospective cohort study in Berlin, Germany. Patients with long-term opioid therapy treated in 2 university-affiliated outpatient pain facilities at the Charité hospital were included from January 2013 to August 2013. Constipation was rated in a self-assessment using a numeric rating scale from 0 to 10 (Con-NRS) and compared with results from a structured assessment based on ROME-III criteria. Altogether, 171 patients were included. Incidence of constipation was 49% of patients. The receiver-operating characteristic of Con-NRS achieved an area under the curve of 0.814 (AUC 95% confidence interval 0.748–0.880, P < 0.001). Con-NRS ≥ 1 achieved sensitivity and specificity of 79.7% and 77.2%, respectively. The positive predictive value and the negative predictive value were 70.3% and 81.6%, respectively. Overall diagnostic performance of a concise 11-item Likert scale for constipation was moderate. Although patients with long-term opioid therapy are familiar with numeric rating scales, a significant number of patients with constipation were not identified. The instrument may be additionally useful to facilitate individualized therapeutic decision making and to control therapeutic success when measured repetitively. Wolters Kluwer Health 2015-12-18 /pmc/articles/PMC5058907/ /pubmed/26683935 http://dx.doi.org/10.1097/MD.0000000000002227 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 3300
Tafelski, Sascha
Bellin, Felicitas
Denke, Claudia
Beutlhauser, Torsten
Fritzsche, Thomas
West, Christina
Schäfer, Michael
Diagnostic Performance of Self-Assessment for Constipation in Patients With Long-Term Opioid Treatment
title Diagnostic Performance of Self-Assessment for Constipation in Patients With Long-Term Opioid Treatment
title_full Diagnostic Performance of Self-Assessment for Constipation in Patients With Long-Term Opioid Treatment
title_fullStr Diagnostic Performance of Self-Assessment for Constipation in Patients With Long-Term Opioid Treatment
title_full_unstemmed Diagnostic Performance of Self-Assessment for Constipation in Patients With Long-Term Opioid Treatment
title_short Diagnostic Performance of Self-Assessment for Constipation in Patients With Long-Term Opioid Treatment
title_sort diagnostic performance of self-assessment for constipation in patients with long-term opioid treatment
topic 3300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058907/
https://www.ncbi.nlm.nih.gov/pubmed/26683935
http://dx.doi.org/10.1097/MD.0000000000002227
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