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Burden and Treatment of Opioid-Induced Constipation in Adults with Chronic Noncancer Pain.

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eMediNexus    11 September 2018

A new study published in Pain Medicine evaluated the dynamics of interactions, identified communication gaps, and assessed the functional burden of opioid-induced constipation (OIC) on patients lives. This was a retrospective analysis of more than 120,000 patient-provider conversations, in out-patient settings of United States. Demographics and prespecified opioid-induced constipation conversation characteristics were evaluated. Overall, 216 patient-provider discussions were included; 76.4% patients were 50 years of age or above. The results revealed that a majority of the conversations were with either pain management specialists or primary care physicians. Among patients, 64.4% reported experiencing symptoms of constipation while health care providers reported that symptoms of constipation could be caused by opioid use in 75.5% of patients with constipation. However, 82.4% providers did not probe specific constipation symptoms. Meanwhile 11.5% patients with OIC discussed its burden with their providers which included emergency room visits and reduced food or fluid intake. But, no specific action was recommended for 33.8% of these patients with constipation. From the findings, it was inferred that opioids are not cited as a cause of constipation in approximately one-quarter of patients with opioid-induced constipation, and no clear treatment plan or guidance was being recommended for one-third of patients. Therefore, more education was recommended to improve patient-provider communication about opioid-induced constipation.

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