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The patient burden of opioid-induced constipation: New insights from a large, multinational survey in five European countries

Andresen, V; Banerji, V; Hall, G; Lass, A; Emmanuel, AV; (2018) The patient burden of opioid-induced constipation: New insights from a large, multinational survey in five European countries. United European Gastroenterology Journal , 6 (8) pp. 1254-1266. 10.1177/2050640618786145. Green open access

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Abstract

BACKGROUND: Despite its high prevalence, opioid-induced constipation (OIC) remains under-recognised and undertreated, and its true impact on wellbeing and quality of life (QoL) may be underestimated. METHODS: A quantitative, questionnaire-based international survey was conducted. RESULTS: Weak-opioid users appeared as bothered by constipation as strong-opioid users (38% vs 40%, respectively; p = 0.40), despite it causing less-severe physical symptoms and impact on QoL. Strong-opioid users meeting Rome IV OIC criteria appeared to experience greater symptomatic and biopsychosocial burden from constipation than those not satisfying these criteria. Almost one-fifth of respondents were dissatisfied with their current constipation treatment and around one-third found balancing the need for adequate pain relief with constipation side effects challenging. Consequently, more than half failed to adhere to their prescribed treatment regimens, or resorted to suboptimal strategies, e.g. 40% reduced their opioid intake, to relieve constipation. Almost 60% of healthcare professionals did not adequately counsel patients about constipation as a common side effect of opioid use. CONCLUSIONS: Findings suggest that both weak- and strong-opioid users suffer comparable bother and decreased QoL, Rome IV criteria can identify patients with more-severe OIC, but may underdiagnose patients showing fewer symptoms, and increased education is needed to manage patients’ expectations and enable improved OIC self-management.

Type: Article
Title: The patient burden of opioid-induced constipation: New insights from a large, multinational survey in five European countries
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/2050640618786145
Publisher version: https://doi.org/10.1177%2F2050640618786145
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Opioid-induced constipation, Rome IV criteria, patient survey, biopsychosocial burden, adherence, management and counselling
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/10076923
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