Opioid-induced constipation (OIC): Prevalence and impact of quality of life of patient in pain clinic

Abstract

Background: Opioids widely used for relieving
pain could cause constipation. Objective: To determine
1) prevalence of opioid-induced constipation (OIC)
and its impact on quality of life (QoL) 2) satisfaction
with laxative, pain treatment and self-management
for constipation. Methods: The prospective cohort
was conducted between October 2016 and January
2017 at pain clinic, Ramathibodi Hospital. Sixty
patients age > 18 years had been taking either weak or
strong opioids at least one month. Data were collected
using the 36-Item Short Form Health Survey
(SF-36) questionnaire at 1st and 4th week. Presence of
constipation based on Rome III criteria and self-
management were evaluated at 2nd week. Results: The
prevalence of OIC was 63.33%. Cancer patients were
identified 29% of all OIC. The SF-36 score of general
heath at 1st week was lower in constipated (n = 38)
than non-constipated patients (n = 22) (30.29 + 19.31
vs 42.64 + 28.10, p = 0.02). At 4th week visit, the scores
of general heath in physical aspect, vitality in emotional
aspect and mental health in patients with persistent
constipation were significantly lower than in the
ones with improved symptom from constipation
(32.24 + 23.77 vs 50.08 + 20.73, p = 0.012), (45.2 + 20.23
vs 57.31 + 14.95, p = 0.020) and (54.72 + 21.35 vs
71.69 + 16.04, p = 0.015), respectively. Most of opioid
used patients had using self-management (84.21%).
The satisfaction for laxative and pain treatment was
high. Conclusion: OIC is a common side effect for
pain treatment and affect QoL both physical and
emotional aspects. Despite the aggressive laxative use,
symptoms remain persist; however, the satisfaction
for laxative and pain treatment were still high.