Soichi Fumita1, Hisao Imai2, Toshiyuki Harada3, Toshio Noriyuki4, Makio Gamoh5, Yusaku Akashi1, Hiroki Sato6, Yoshiyuki Kizawa7, Akihiro Tokoro8. 1. Department of Medical Oncology, Kindai University Nara Hospital, Ikoma, Japan. 2. Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ohta, Japan. 3. Center for Respiratory Diseases, JCHO Hokkaido Hospital, Sapporo, Japan. 4. Department of Surgery, Onomichi General Hospital, Onomichi. 5. Department of Medical Oncology, Osaki Citizen Hospital, Osaki, Japan. 6. Medical Affairs, Shionogi & Co., Ltd., Osaka, Japan. 7. Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. 8. Department of Psychosomatic Internal Medicine and Supportive and Palliative Care Team, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan. Electronic address: tokoro.akihiro.qb@mail.hosp.go.jp.
Abstract
CONTEXT: Many patients who have cancer consider opioid-induced constipation (OIC) to be a burdensome side effect of opioid treatment. OBJECTIVES: To evaluate patient-reported outcomes in Japanese patients with cancer pain and OIC. METHODS: This prospective observational study evaluated OIC incidence for two weeks in patients with cancer after they initiated strong opioid therapy. Rome IV diagnostic criteria, a physician's diagnosis, spontaneous bowel movements, Bowel Function Index score, and patients' daily self-assessments were used. Changes from baseline in Patient Assessment of Constipation Symptoms and Patient Assessment of Constipation Quality of Life (PAC-QOL) scores were compared between patients with and without OIC. Patients and health care providers (HCPs) completed study-specific questionnaires regarding OIC burden, treatment satisfaction, and patient-provider communications. RESULTS: Among 212 enrolled patients, the incidence of OIC was 47.6% by patients' self-assessments, with a cumulative incidence of 30.2% by Day 3 and 43.5% by Day 7. Patient Assessment of Constipation Symptoms and PAC-QOL overall scores from patients with OIC worsened significantly from baseline compared with patients without OIC by all diagnostic criteria, except for spontaneous bowel movement frequency for PAC-QOL. Patients and HCPs were generally satisfied with OIC treatment; however, 53.5% of patients and approximately 40.0% of HCPs reported that OIC affected pain management. Most patients and HCPs reported that OIC conditions were sufficiently or essentially communicated. CONCLUSION: After starting opioid therapy, patients recognized OIC onset and its impact on cancer pain management, highlighting the need for effective patient-provider communications, diagnosis, and treatment of OIC to improve QOL for patients with cancer receiving opioid analgesics.
CONTEXT: Many patients who have cancer consider opioid-induced constipation (OIC) to be a burdensome side effect of opioid treatment. OBJECTIVES: To evaluate patient-reported outcomes in Japanese patients with cancer pain and OIC. METHODS: This prospective observational study evaluated OIC incidence for two weeks in patients with cancer after they initiated strong opioid therapy. Rome IV diagnostic criteria, a physician's diagnosis, spontaneous bowel movements, Bowel Function Index score, and patients' daily self-assessments were used. Changes from baseline in Patient Assessment of Constipation Symptoms and Patient Assessment of Constipation Quality of Life (PAC-QOL) scores were compared between patients with and without OIC. Patients and health care providers (HCPs) completed study-specific questionnaires regarding OIC burden, treatment satisfaction, and patient-provider communications. RESULTS: Among 212 enrolled patients, the incidence of OIC was 47.6% by patients' self-assessments, with a cumulative incidence of 30.2% by Day 3 and 43.5% by Day 7. Patient Assessment of Constipation Symptoms and PAC-QOL overall scores from patients with OIC worsened significantly from baseline compared with patients without OIC by all diagnostic criteria, except for spontaneous bowel movement frequency for PAC-QOL. Patients and HCPs were generally satisfied with OIC treatment; however, 53.5% of patients and approximately 40.0% of HCPs reported that OIC affected pain management. Most patients and HCPs reported that OIC conditions were sufficiently or essentially communicated. CONCLUSION: After starting opioid therapy, patients recognized OIC onset and its impact on cancer pain management, highlighting the need for effective patient-provider communications, diagnosis, and treatment of OIC to improve QOL for patients with cancer receiving opioid analgesics.
Authors: Bruce H Chamberlain; Michelle Rhiner; Neal E Slatkin; Nancy Stambler; Robert J Israel Journal: J Pain Res Date: 2021-09-01 Impact factor: 3.133