alexa The Clinical Challenge of Opioid-induced Constipation:
ISSN: 2329-9126

Journal of General Practice
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Research Article

The Clinical Challenge of Opioid-induced Constipation: Insights from the Opioid-induced Constipation Clinical Audit

Peter Katelaris1,* and George Krassas2
1University of Sydney, Concord Clinical School, Gastroenterology and Liver Centre, Concord Hospital, Australia
2Scius Healthcare Solutions Pty Ltd, Sydney, Australia
Corresponding Author : Peter Katelaris
Associate Professor, MBBS, FRACP, MD (Lond), AGAF
Clinical Associate Professor Medicine, University of Sydney
Concord Clinical School, Gastroenterology and Liver Centre
Concord Hospital, Australia
Tel: 612 9767 7908
E-mail: [email protected]
Received: December 27, 2015; Accepted: January 04, 2016; Published: January 15, 2016
Citation: Katelaris P, Krassas G (2016) The Clinical Challenge of Opioid-induced Constipation: Insights from the Opioid-induced Constipation Clinical Audit. J Gen Pract 4:221. doi:10.4172/2329-9126.1000221
Copyright: © 2016 Katelaris P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Objective: Constipation is the most common and often most debilitating adverse effect associated with opioid use. Opioid-induced constipation persists for the duration of therapy. The aims of this clinical audit were to investigate the GP management of opioid-induced constipation, gain insights on how to improve its management and determine if the audit could improve the management of opioid-induced constipation. Methods: Using quantitative questionnaires, GPs prospectively evaluated their management of constipation in patients prescribed strong opioid analgesic for chronic non-cancer pain, across two audit cycles. The audited patients completed a quantitative survey after the initial GP visit and returned the completed survey to the GP in a sealed envelope. The patient questionnaire was used to assess consistency between patients’ and GPs’ evaluation and management of constipation. Following each cycle GPs received feedback and a decision support tool. Results: Opioid-induced constipation was reported by 50.5% of patients, but its presence was underestimated by GPs, with GPs failing to recognise opioid-induced constipation in a third of patients. GP management of opioidinduced constipation improved during the audit with improvements in the frequency of assessment and the proactive management of constipation. Conclusion: GPs need to regularly ask all patients taking opioid analgesics about the presence of constipation. Questioning should include both objective and subjective measures to assist the detection and assessment of opioidinduced constipation. The high prevalence of opioid-induced constipation necessitates proactive management at the time of opioid initiation and for the duration of opioid therapy


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