(120) Impact of opioid-induced constipation on opioid therapy management among chronic opioid users based on a patient survey

Abstract

Management of persistent pain in patients with opioid-induced constipation (OIC) is not optimal. The objective was to measure the impact of OIC on pain management and adherence to opioid medication. Data were collected from an online self-reported survey of 504 adults ($18 years old) using opioids chronically (>30 days) for pain and who had reported constipation as a side-effect related to opioid use. Adherence to opioids was measured using the Morisky Medication Adherence Scale (MMAS-4, 0=high to 4=low adherence), and questions focused on opioids and OIC treatment history, pain severity (0=no pain to 10=worst pain), and modifications to opioid therapy management due to constipation was collected. The average age of respondents was 57.4 years (standard deviation [SD] =11.8), 50.4% (n=254) were female, 80.6% (n=406) were using opioids for more than a year, and 70% (n=353) were treating their constipation for 3.2 years (SD=3.5). On average patients missed 2 doses of opioid treatments in the past 14 days and only 30% (n=151) were completely adherent to their opioid medication (MMAS=0). Over 80% of respondents reported experiencing pain for half the day or more and for 5 or more days per week. Patients reported a mean pain severity score of 6.8 (SD=1.8). Overall 49.6% (n=250) of patients reportedmodifications to their opioid therapy because of constipation in the past 6 months: 37.7% (n=190) reduced, 14.1% (n=71) switched and 36.9% (n=186) skipped doses of their opioid medication. Approximately 20% (n=98) discontinued an opioid medication because of constipation. Almost half of study respondents modified their opioid therapy to manage constipation side-effects. This analysis showed that constipation related to use of opioids can impact adherence to opioid therapy and pain management. Sponsored by Takeda Pharmaceuticals International, Inc.