Abstract
Background High rates of opioid use for chronic noncancer pain (CNCP) have been reported worldwide, despite its association with adverse events, inappropriate use, and limited analgesic effect. Opioid-induced constipation (OIC) is the most prevalent and disabling adverse effect associated with opioid therapy. Our aim was to assess the incidence, health related quality of life (HRQOL), and disability in OIC patients. Methods A prospective cohort study was performed, with 6 months of follow-up, of adult CNCP patients consecutively admitted in 4 multidisciplinary pain clinics (MPC). Demographic and clinical data have been collected. Brief Pain Inventory (BPI) and Short version of Treatment Outcomes in Pain Survey (S-TOPS) were used to measure functional outcomes and HRQOL. OIC was assessed using Bowel Function Index (BFI). Results 694 patients were recruited. OIC prevalence at baseline was 25.8%. At 6 months, OIC incidence was 24.8%. Female gender (OR = 1.65, p = 0.039), opioid therapy (OR 1.65, p = 0.026), and interference pain score on BPI (OR 1.10, p = 0.009) were identified as OIC independent predictors. OIC patients presented higher disability and pain interference and severity scores. OIC patients reported less satisfaction with outcome (p = 0.038). Discussion Constipation is a common adverse event among opioid users with major functional and quality of life impairment. These findings emphasise the need of OIC adequate assessment and management.
Highlights
Chronic pain is a major public healthcare problem worldwide [1]
Pain Research and Treatment use in chronic noncancer pain (CNCP) treatment is recommended in several guidelines [5,6,7], and high prescription rates were observed in several countries of Europe and the United States in the last decade [8,9,10], there has been a decreasing trend in prescription rates since 2011 [10, 11]
The primary aim of this study was to assess and estimate the incidence of Opioid-induced constipation (OIC), health related quality of life and disability in CNCP patients followed in Chronic Pain Clinics
Summary
Chronic pain is a major public healthcare problem worldwide [1] It has an estimated prevalence of 20% in the European population and is an important cause of quality of life impairment and substantial burden in healthcare systems [2,3,4]. High rates of opioid use for chronic noncancer pain (CNCP) have been reported worldwide, despite its association with adverse events, inappropriate use, and limited analgesic effect. Our aim was to assess the incidence, health related quality of life (HRQOL), and disability in OIC patients. Constipation is a common adverse event among opioid users with major functional and quality of life impairment. These findings emphasise the need of OIC adequate assessment and management
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