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Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort

OBJECTIVES: This research describes the prevalence and covariates associated with opioid-induced constipation (OIC) in an observational cohort study utilizing a national veteran cohort and integrated data from the Center for Medicare and Medicaid Services (CMS). METHODS: A cohort of 152,904 veterans...

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Autores principales: FitzHenry, Fern, Eden, Svetlana K., Denton, Jason, Cao, Hui, Cao, Aize, Reeves, Ruth, Chen, Guanhua, Gobbel, Glenn, Wells, Nancy, Matheny, Michael E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149448/
https://www.ncbi.nlm.nih.gov/pubmed/32318129
http://dx.doi.org/10.1155/2020/5165682
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author FitzHenry, Fern
Eden, Svetlana K.
Denton, Jason
Cao, Hui
Cao, Aize
Reeves, Ruth
Chen, Guanhua
Gobbel, Glenn
Wells, Nancy
Matheny, Michael E.
author_facet FitzHenry, Fern
Eden, Svetlana K.
Denton, Jason
Cao, Hui
Cao, Aize
Reeves, Ruth
Chen, Guanhua
Gobbel, Glenn
Wells, Nancy
Matheny, Michael E.
author_sort FitzHenry, Fern
collection PubMed
description OBJECTIVES: This research describes the prevalence and covariates associated with opioid-induced constipation (OIC) in an observational cohort study utilizing a national veteran cohort and integrated data from the Center for Medicare and Medicaid Services (CMS). METHODS: A cohort of 152,904 veterans with encounters between 1 January 2008 and 30 November 2010, an exposure to opioids of 30 days or more, and no exposure in the prior year was developed to establish existing conditions and medications at the start of the opioid exposure and determining outcomes through the end of exposure. OIC was identified through additions/changes in laxative prescriptions, all-cause constipation identification through diagnosis, or constipation related procedures in the presence of opioid exposure. The association of time to constipation with opioid use was analyzed using Cox proportional hazard regression adjusted for patient characteristics, concomitant medications, laboratory tests, and comorbidities. RESULTS: The prevalence of OIC was 12.6%. Twelve positively associated covariates were identified with the largest associations for prior constipation and prevalent laxative (any laxative that continued into the first day of opioid exposure). Among the 17 negatively associated covariates, the largest associations were for erythromycins, androgens/anabolics, and unknown race. CONCLUSIONS: There were several novel covariates found that are seen in the all-cause chronic constipation literature but have not been reported for opioid-induced constipation. Some are modifiable covariates, particularly medication coadministration, which may assist clinicians and researchers in risk stratification efforts when initiating opioid medications. The integration of CMS data supports the robustness of the analysis and may be of interest in the elderly population warranting future examination.
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spelling pubmed-71494482020-04-21 Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort FitzHenry, Fern Eden, Svetlana K. Denton, Jason Cao, Hui Cao, Aize Reeves, Ruth Chen, Guanhua Gobbel, Glenn Wells, Nancy Matheny, Michael E. Pain Res Manag Research Article OBJECTIVES: This research describes the prevalence and covariates associated with opioid-induced constipation (OIC) in an observational cohort study utilizing a national veteran cohort and integrated data from the Center for Medicare and Medicaid Services (CMS). METHODS: A cohort of 152,904 veterans with encounters between 1 January 2008 and 30 November 2010, an exposure to opioids of 30 days or more, and no exposure in the prior year was developed to establish existing conditions and medications at the start of the opioid exposure and determining outcomes through the end of exposure. OIC was identified through additions/changes in laxative prescriptions, all-cause constipation identification through diagnosis, or constipation related procedures in the presence of opioid exposure. The association of time to constipation with opioid use was analyzed using Cox proportional hazard regression adjusted for patient characteristics, concomitant medications, laboratory tests, and comorbidities. RESULTS: The prevalence of OIC was 12.6%. Twelve positively associated covariates were identified with the largest associations for prior constipation and prevalent laxative (any laxative that continued into the first day of opioid exposure). Among the 17 negatively associated covariates, the largest associations were for erythromycins, androgens/anabolics, and unknown race. CONCLUSIONS: There were several novel covariates found that are seen in the all-cause chronic constipation literature but have not been reported for opioid-induced constipation. Some are modifiable covariates, particularly medication coadministration, which may assist clinicians and researchers in risk stratification efforts when initiating opioid medications. The integration of CMS data supports the robustness of the analysis and may be of interest in the elderly population warranting future examination. Hindawi 2020-03-29 /pmc/articles/PMC7149448/ /pubmed/32318129 http://dx.doi.org/10.1155/2020/5165682 Text en Copyright © 2020 Fern FitzHenry et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
FitzHenry, Fern
Eden, Svetlana K.
Denton, Jason
Cao, Hui
Cao, Aize
Reeves, Ruth
Chen, Guanhua
Gobbel, Glenn
Wells, Nancy
Matheny, Michael E.
Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort
title Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort
title_full Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort
title_fullStr Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort
title_full_unstemmed Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort
title_short Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort
title_sort prevalence and risk factors for opioid-induced constipation in an older national veteran cohort
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149448/
https://www.ncbi.nlm.nih.gov/pubmed/32318129
http://dx.doi.org/10.1155/2020/5165682
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