More Than Half of Surveyed Chronic Pain Patients Report Opioid-Induced Constipation

MedicalResearch.com Interview with:

Dr. Joseph Pergolizzi MD Senior Partner and Director of Research Naples Anesthesia and Pain Associates Naples, Florida Adjunct Assistant Professor Johns Hopkins University School of Medicine Baltimore, Maryland

Dr. Pergolizzi

Dr. Joseph Pergolizzi MD
Senior Partner and Director of Research
Naples Anesthesia and Pain Associates
Naples, Florida

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: There are roughly 100 million Americans living with chronic pain and many battle debilitating side effects because of their pain medication, including Painstipation otherwise known as opioid-induced constipation (OIC.) In fact, OIC is the most common side effect with approximately 40-80 percent of patients on chronic opioid therapy experiencing it.

To better understand this community, the Painstipation survey, conducted by Salix Pharmaceuticals in partnership with the U.S. Pain Foundation, surveyed 441 U.S. adults with chronic pain who were on opioid therapy and suffering from OIC. It gave great insight into this community as it found:

  • More than half (51 percent) of chronic pain patients have been suffering from opioid-induced constipation  for three years or longer
  • Most patients (73 percent) agree that one of the biggest challenges of having OIC is that medications don’t work quickly enough to relieve pain associated with OIC.
  • 53 percent of patients say they want relief for OIC in under four hours
  • Only half of patients surveyed (73 percent) surveyed said they were informed by their doctors that taking opioid medications might result in constipation before they began taking them
  • 77 percent of respondents reported suffering from OIC for at least one year
  • When asked, roughly one-third (32 percent) of patients reported that their doctor does not talk to them specifically about potential adverse drug-to-drug interactions (DDI) of their current prescription and/or over-the-counter medications.

 

MedicalResearch.com: What should readers take away from your report? 

Response: Opioid-induced constipation is the most common related side effect of chronic opioid therapy and HCPs need to discuss this with their patients. To optimize our management of those appropriate patients, we need to be cognizant of the effect OIC has on a patient’s functionality and quality of life. Patients want a reliable, fast option to relieve their OIC, so it’s important for HCPs to have an open dialogue with their patients when it relates to the impact of opioids and their bowel habits.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: As a result of this study, I have various recommendations for future research. For example, I think it’s important that we get a thorough understanding of the impact OIC has on our patients’ daily living activities and overall quality of life. It’s equally as important to explore the various treatment options that we can present to our patients when the first line of over-the-counter options are inadequate or not tolerated by the patient.

Research should also focus on the real world clinical paradigm that HCPs face when managing chronic pain patients on opioid therapy. This should take into consideration that these patients likely have other co-morbidities that are being managed medically through different medications. For example, the survey found that 47 percent of the patients surveyed were taking 6-10 prescription medications on a regular basis. When an HCP makes a decision related to targeted therapy for opioid-induced constipation, they should also take into account the possibility of potential harm to the patient— especially considering the fact that polypharmacy could lead to increased potential relevant drug to drug interactions.

Disclosures: Dr. Pergolizzi is a consultant for Salix Pharmaceuticals. 

Citations:

An online survey of 441 U.S. adults, ages 18+ living with chronic pain who are on opioid therapy and currently suffer from opioid-induced constipation 

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Last Updated on April 9, 2018 by Marie Benz MD FAAD