PGI22 - The Impact Of Opioid-Induced Constipation (Oic) On Quality Of Life – A 10-Year Literature Review

Abstract

Constipation is the most common and often most debilitating side effect of opioid therapy for chronic pain. It has been reported that some patients rank constipation as a more common source of distress than their pain. Opioid-induced constipation (OIC) compounds the burden in these patients and may lead to opioid alterations in dosing regimen, discontinuation, inadequate pain management, and increased cost of care Using standard methodology, a targeted literature review was undertaken of studies published in the last 10 years (2002–2012) reporting quality of life (QOL) in patients with OIC receiving opioid therapy for cancer or noncancer pain. The review focused on PubMed (MEDLINE) and Embase; abstracts from recent key conferences/meetings for gastroenterology and pain were also reviewed A limited number of publications (one review, four surveys, two small qualitative studies) were identified. While only the PAC-QOL has been validated in this population, various additional instruments were used to describe OIC impact on QOL, such as EQ-5D, the SF-8 questionnaire, a 5-point scale, an 11-point scale, and qualitative descriptions. The burden of OIC on patient QOL was found to be considerable, with OIC patients experiencing worse QOL than patients without OIC in all four surveys. Of note, one survey showed that increasing severity of constipation correlated with decreasing QOL, while another indicated that patients with severe constipation were less satisfied with their pain treatment versus patients with mild, moderate, or no constipation. Mean satisfaction with pain treatment with no, mild, moderate and severe constipation was 6.6, 6.6, 6.2 and 5.2 (10-very satisfied) Current literature on the impact of OIC on QOL is very limited but consistently suggests that OIC adversely impacts QOL. More research is needed to fully quantify the impact on QOL and standardize research methodology. Alleviation of OIC may improve QOL and optimize pain management among these patients