174 An observational study of opioid-induced constipation (oic). Issue Volume 8: Issue (2018)Supplement 1 (1st March 2018)

• Record Type: Journal Article
• Authors: Leach, C; Davies, A
• Is Part Of: BMJ supportive & palliative care. Volume 8: Issue (2018)Supplement 1
• Page Start: A73
• Page End: A73
• Publication Date: 2018-03-01
• Subjects: Palliative treatment -- Periodicals; Terminal care -- Periodicals; 616.029
• DOI: 10.1136/bmjspcare-2018-ASPabstracts.201
• Languages: English
• ISSNs: 2045-435X

Abstract

Abstract : Background: Opioid-induced constipation (OIC) is common, although there is a lack of consensus on diagnostic criteria, and as a result a lack of consistency around the prevalence (with resultant impact on patient care). This study primarily aims to compare different methods of assessing OIC in a heterogeneous group of patients with cancer. Methods: Data was collected on 100 consecutive patients with cancer that were receiving regular opioid analgesics. Constipation was assessed using a simple question ( 'are you constipated'), the EAPC criteria, the so-called 'Camilleri' criteria (for OIC), the Rome IV criteria (for OIC), and assessment by a specialist palliative care professional. The degree of OIC was assessed using the bowel function index (BFI). Results: The median age was 62 (range 37–86); 46% were female, 54% were male. Cancer diagnoses were as follows: 34% gastrointestinal, 13% gynaecological, 12% head and neck, 11% urological, 11% breast, 10% lung, 5% haematological, 2% skin, 2% malignancy of unknown origin. The prevalence of constipation using the different diagnostic criteria was: Simple question – 35% (with 17% 'unsure') EAPC criteria – 29% (with 6% 'unsure') Camilleri criteria (for OIC) – 63% (with 6% 'unsure') Rome IV criteria (for OIC) – 71% Assessment by specialist palliative care professional – 68% had constipation; of which 44% had OIC. Of the patients identified as having OIC from the Rome IV criteria, 30% thought they were constipated, and the mean BFI was 65. In contrast, the mean BFI for patients that did not meet the Rome IV criteria was 32. Conclusions: The prevalence of OIC depends on the diagnostic criteria employed. It appears that many patients with OIC do not realise that they are in fact constipated (based on objective criteria).