Opioid-induced constipation in patients with cancer: a "real-world," multicentre, observational study of diagnostic criteria and clinical features.
Journal
Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
pubmed:
24
7
2020
medline:
15
5
2021
entrez:
24
7
2020
Statut:
ppublish
Résumé
The aim of this study was to investigate opioid-induced constipation (OIC) in a large cohort of "real-world" patients with cancer; the objectives were to determine the prevalence of OIC, the utility of a simple screening question, the accuracy of the Rome IV diagnostic criteria, the clinical features of OIC (physical and psychological), and the impact of OIC (quality of life). One thousand patients with cancer were enrolled in the study, which involved completion of the Rome IV diagnostic criteria for OIC, the Bowel Function Index, the Patient Assessment of Constipation Quality of Life questionnaire, and the Memorial Symptom Assessment Scale-Short Form. Participants also underwent a thorough clinical assessment by an experienced clinician (ie, "gold-standard" assessment of OIC). Fifty-nine percent of patients were clinically assessed as having OIC, 2.5% as having another cause of constipation, and 19% as not having constipation but were taking regular laxatives. The simple screening question produced a number of false-negative results (19% of patients), whereas the Rome IV diagnostic criteria had an accuracy of 81.9%. Patients with OIC had more symptoms overall, higher Memorial Symptom Assessment Scale-Short Form subscale scores (and total score), and higher Patient Assessment of Constipation Quality of Life questionnaire subscale scores (and the overall score). Opioid-induced constipation was not associated with demographic factors, cancer diagnosis, performance status, or opioid equivalent dosage: OIC was associated with opioid analgesic, with patients receiving tramadol and transdermal buprenorphine having less constipation. The study confirms that OIC is common among patients with cancer pain and is associated with a spectrum of physical symptoms, a range of psychological symptoms, and an overall deterioration in the quality of life.
Identifiants
pubmed: 32701649
doi: 10.1097/j.pain.0000000000002024
pii: 00006396-202101000-00027
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
309-318Références
Argoff CE, Brennan MJ, Camilleri M, Davies A, Fudin J, Galluzzi KE, Gudin J, Lembo A, Stanos SP, Webster LR. Consensus recommendations on initiating prescription therapies for opioid-induced constipation. Pain Med 2015;16:2324–37.
Bennett M, Cresswell H. Factors influencing constipation in advanced cancer patients: a prospective study of opioid dose, dantron dose and physical functioning. Palliat Med 2003;17:418–22.
British Medical Association and the Royal Pharmaceutical Society. British National Formulary 74. Basingstoke: Pharmaceutical Press, 2017.
Camilleri M, Drossman DA, Becker G, Webster LR, Davies AN, Mawe GM. Emerging treatments in neurogastroenterology: a multidisciplinary working group consensus statement on opioid-induced constipation. Neurogastroenterol Motil 2014;26:1386–95.
Caraceni A, Hanks G, Kaasa S, Bennett MI, Brunelli C, Cherny N, Dale O, De Conno F, Fallon M, Hanna M, Haugen DF, Juhl G, King S, Klepstad P, Laugsand EA, Maltoni M, Mercadante S, Nabal M, Pigni A, Radbruch L, Reid C, Sjogren P, Stone PC, Tassinari D, Zeppetella G. Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncol 2012;13:e58–68.
Chang VT, Hwang SS, Feuerman M, Kasimis BS, Thaler HT. The Memorial Symptom Assessment Scale short form (MSAS-SF). Cancer 2000;89:1162–71.
Cherny N, Ripamonti C, Pereira J, Davis C, Fallon M, McQuay H, Mercadante S, Pasternak G, Ventafridda V. Strategies to manage the adverse effects of oral morphine: an evidence-based report. J Clin Oncol 2001;19:2542–54.
Crockett SD, Greer KB, Heidelbaugh JJ, Falck-Ytter Y, Hanson BJ, Sultan S. American Gastroenterological Association Institute guideline on the medical management of opioid-induced constipation. Gastroenterology 2019;156:218–26.
Davies A, Leach C, Caponero R, Dickman A, Fuchs D, Paice J, Emmanuel A. MASCC recommendations on the management of constipation in patients with advanced cancer. Support Care Cancer 2020;28:23–33.
Dhingra L, Shuk E, Grossman B, Strada A, Wald E, Portenoy A, Knotkova H, Portenoy Rl. A qualitative study to explore psychological distress and illness burden associated with opioid-induced constipation in cancer patients with advanced disease. Palliat Med 2013;27:447–56.
Drossman DA, Chang L, Chey WD, Kellow J, Tack J, Whitehead WE. Rome IV functional gastrointestinal disorders: disorders of gut-brain interaction. 4th ed. Raleigh: The Rome Foundation, 2016.
Fallon MT, Hanks GW. Morphine, constipation and performance status in advanced cancer patients. Palliat Med 1999;13:159–60.
Friedrichsen M, Erichsen E. The lived experience of constipation in cancer patients in palliative hospital-based home care. Int J Palliat Nurs 2004;10:321–5.
Gaertner J, Siemens W, Camilleri M, Davies A, Drossman DA, Webster LR, Becker G. Definitions and outcome measures of clinical trials regarding opioid-induced constipation: a systematic review. J Clin Gastroenterol 2015;49:9–16.
Hanson B, Siddique SM, Scarlett Y, Sultan S. American Gastroenterological Association institute technical review on the medical management of opioid-induced constipation. Gastroenterology 2019;156:229–53.
Hjalte F, Berggren A, Bergendahl H, Hjortsberg C. The direct and indirect costs of opioid-induced constipation. J Pain Symptom Manage 2010;40:696–703.
Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R. Bowel disorders. Gastroenterology 2016;150:1393–407.
Larkin PJ, Cherny NI, La Carpia D, Guglielmo M, Ostgarthe C, Scotte F, Ripamonti C. Diagnosis, assessment and management of constipation in advanced cancer: ESMO Clinical Practice Guidelines. Ann Oncol 2018;29(suppl 4):iv94–108.
Laugsand EA, Fladvad T, Skorpen F, Maltoni M, Kaasa S, Fayers P, Klepstad P. Clinical and genetic factors associated with nausea and vomiting in cancer patients receiving opioids. Eur J Cancer 2011;47:1682–91.
Laugsand EA, Jakobsen G, Kaasa S, Klepstad P. Inadequate symptom control in advanced cancer patients across Europe. Support Care Cancer 2011;19:2005–14.
Laugsand EA, Skorpen F, Kaasa S, Sabatowski R, Strasser F, Fayers P, Klepstad P. Genetic and non-genetic factors associated with constipation in cancer patients receiving opioids. Clin Transl Gastroenterol 2015;6:e90.
Lindberg G, Hamid SS, Malfertheiner P, Thomsen O, Fernandez LB, Garisch J, Thomson A, Goh K, Tandon R, Fedail S, Wong B, Khan A, Krabshuis J, Le Mair A. World Gastroenterology Organisation global guideline: constipation: a global perspective. J Clin Gastroenterol 2011;45:483–7.
Marquis P, De La Loge C, Dubois D, McDermott A, Chassany O. Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire. Scand J Gastroenterol 2005;40:540–51.
Nee J, Zakari M, Sugarman MA, Whelan J, Hirsch W, Sultan S, Ballou S, Iturrino J, Lembo A. Efficacy of treatments for opioid-induced constipation: systematic review and meta-analysis. Clin Gastroenterol Hepatol 2018;16:1569–84.
Noguera A, Centeno C, Librada S, Nabal M. Clinical use of oral laxatives in palliative care services in Spain. Support Care Cancer 2010;18:1491–4.
Oken M, Creech R, Tormey D, Horton J, Davis TE, McFadden ET, Carbone PP. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5:649–55.
O'Mahony R, Murthy L, Akunne A, Young J; Guideline Development Group. Synopsis of the National Institute for Health and Clinical Excellence guideline for prevention of delirium. Ann Intern Med 2011;154:746–51.
Oosten AW, Oldenmenger WH, Mathijssen RH, van der Rijt CC. A systematic review of prospective studies reporting adverse events of commonly used opioids for cancer-related pain: a call for the use of standardized outcome measures. J Pain 2015;16:935–46.
Palsson OS, Whitehead WE, van Tilburg MA, Chang L, Chey W, Crowell MD, Keefer L, Lembo AJ, Parkman HP, Rao SS, Sperber A, Spiegel B, Tack J, Vanner S, Walker LS, Whorwell P, Yang Y. Development and validation of the Rome IV Diagnostic Questionnaire for adults. Gastroenterology 2016;150:1481–91.
Pantham G, Post A, Venkat D, Einstadter D, Mullen KD. A new look at precipitants of overt hepatic encephalopathy in cirrhosis. Dig Dis Sci 2017;62:2166–73.
Rentz AM, Yu R, Muller-Lissner S, Leyendecker P. Validation of the Bowel Function Index to detect clinically meaningful changes in opioid-induced constipation. J Med Econ 2009;12:371–83.
Sera L, McPherson ML. Management of opioid-induced constipation in hospice patients. Am J Hosp Palliat Med 2018;35:330–5.
Swarm RA, Paice JA, Anghelescu DL, Are M, Bruce JY, Buga S, Chwistek M, Cleeland C, Craig D, Gafford E, Greenlee H, Hansen E, Kamal AH, Kamdar MM, LeGrand S, Mackey S, McDowell MR, Moryl N, Nabell LM, Nesbit S, O'Connor N, Rabow MW, Rickerson E, Shatsky R, Sindt J, Urba SG, Youngwerth JM, Hammond LJ, Gurski LA. Adult cancer pain, version 3.2019, NCCN clinical practice guidelines in Oncology. J Natl Compr Canc Netw 2019;17:977–1007.
Sykes NP. Constipation and diarrhoea. In: Cherny NI, Fallon MT, Kaasa S, Portenoy RK, Currow DC, editors. Oxford textbook of palliative medicine. 5th ed. Oxford: Oxford University Press, 2015. pp. 675–85.
Tassinari D, Sartori S, Tamburini E, Scarpi E, Raffaeli W, Tombesi P, Maltoni M. Adverse effects of transdermal opiates treating moderate-severe cancer pain in comparison to long-acting morphine: a meta-analysis and systematic review of the literature. J Palliat Med 2008;11:492–501.
Twycross R, Wilcock A, Howard P. Palliative Care Formulary. 6th ed. Nottingham: Palliativedrugs.com Ltd, 2017.
Walsh D, Davis M, Ripamonti C, Bruera E, Davies A, Molassiotis A. 2016 updated MASCC/ESMO consensus recommendations: management of nausea and vomiting in advanced cancer. Support Care Cancer 2016;25:333–40.
Walter S, Hallbook O, Gotthard R, Bergmark M, Sjodahl R. A population-based study on bowel habits in a Swedish community: prevalence of faecal incontinence and constipation. Scand J Gastroenterol 2002;37:911–6.
Wolff RF, Aune D, Truyers C, Hernandez AV, Misso K, Riemsma R, Kleijnen J. Systematic review of efficacy and safety of buprenorphine versus fentanyl or morphine in patients with chronic moderate to severe pain. Curr Med Res Opin 2012;28:833–45.