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Medline ® Abstract for Reference 4

of 'Prevention and management of side effects in patients receiving opioids for chronic pain'

Opioid-induced constipation negatively impacts pain management, productivity, and health-related quality of life: findings from the National Health and Wellness Survey.
Bell T, Annunziata K, Leslie JB
J Opioid Manag. 2009;5(3):137.
OBJECTIVE: To characterize the impact of opioid-induced constipation (OIC) on healthcare resource use, work productivity, and health-related quality of life (HRQOL) in patients receiving chronic opioid therapy.
DESIGN: Data were collected via Internet questionnaires during the international National Health and Wellness Survey (NHWS) 2004 from individuals aged>or = 18 years who reported taking opioids for>or = 6 months. Healthcare resource utilization, Work Productivity, and Activity Impairment, and Short-Form 8 (SF-8) questionnaire responses were compared between those who did or did not report OIC.
RESULTS: Data were available from 2,430 individuals receiving opioids, of whom 359 reported OIC. Participants with OIC reported significantly more physician visits (mean difference 3.84 visits; p<0.05) and alternative care provider visits (mean difference 1.73 visits; p<0.05) over the previous 6 months than those without OIC; however, no significant differences in emergency room visits or number of days of hospitalization were observed. Respondents with OIC also reported significantly greater time missed from work, impairment while working, overall work impairment, and activity impairment (p<0.05 for all comparisons). HRQOL scores were significantly lower in the OIC group than those without OIC on both the physical and mental components of the SF-8 questionnaire (p<0.05 for both comparisons).
CONCLUSIONS: The survey results reflect a negative impact of OIC on individuals' HRQOL and on society in terms of healthcare resource use and work productivity beyond that imposed by patients' pain conditions. These findings indicate a need for effective treatment for opioid-induced constipation in patients receiving chronic opioid therapy.
GlaxoSmithKline, Research Triangle Park, NC, USA.