Medication Use Evaluation of Docusate Sodium in Constipation Prophylaxis and Opioid Induced Constipation at the WPB VA HCS Community Living Center.

Wesley Faulkner, Sandra DiScala, Christine Vartan, Belal Dakroub, Michael Silverman, Mythili Bharadwaj
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Abstract

Introduction: Docusate sodium's efficacy is widely debated. Several studies on opioid induced constipation (OIC) concluded that docusate sodium vs either placebo or in combination with sennosides provided no benefit.

Objective: This medication use evaluation aimed to investigate constipation treatment trends within the West Palm Beach VA Healthcare System Community Living Center, and to assess the therapeutic effectiveness of docusate sodium.

Methods: This was a retrospective review of data extracted from April 1, 2022, to September 30, 2022. Patients were included if they had oral orders for docusate sodium, sennosides, lactulose, and/or polyethylene glycol. Patients without active bowel regimen medications were excluded. Requirements for rescue constipation medication was evaluated.

Results: A total of 98 patients were reviewed. Docusate sodium was used in 43% (n = 42/98) of patients. Rescue medications were needed in 58% (n = 22/38) of patients receiving oral docusate sodium. 52% (n = 29/56) of patients without docusate sodium required rescue medications. For OIC treatment, when docusate sodium was added to other bowel regimens, 59% (n = 17/29) of patients needed a rescue medication, while 66% (n = 19/29) of patients without docusate sodium required a rescue medication. Patients on morphine were given the greatest quantity of rescue constipation medications (73%, n = 16/22).

Conclusion: Oral docusate sodium did not reduce the requirement for rescue constipation medications in the WPB VAHCS CLC population. When evaluating constipation treatment, docusate sodium may supply minimal benefit and could be identified as nonessential for deprescribing efforts. Morphine was the most constipating opioid used in this patient population, requiring more aggressive bowel regimens.

多休塞特钠在WPB VA HCS社区生活中心预防便秘和阿片类药物引起的便秘中的用药评价
文献简介:Docusate钠的功效一直备受争议。几项关于阿片类药物引起的便秘(OIC)的研究得出结论,docusate钠与安慰剂或与sen皂苷联合使用没有任何益处。目的:本药物使用评估旨在调查西棕榈滩VA医疗保健系统社区生活中心的便秘治疗趋势,并评估docusate钠的治疗效果。方法:回顾性分析2022年4月1日至2022年9月30日的数据。如果患者口服了docusate钠、sennosides、乳果糖和/或聚乙二醇,则纳入研究。未使用肠道治疗药物的患者被排除在外。评价便秘抢救用药的要求。结果:共回顾98例患者。43% (n = 42/98)的患者使用Docusate钠。接受口服docusate钠治疗的患者中,58% (n = 22/38)需要抢救药物。52% (n = 29/56)的无钠患者需要抢救药物。对于OIC治疗,当在其他肠道方案中添加docusate钠时,59% (n = 17/29)的患者需要抢救药物,而66% (n = 19/29)的患者不需要抢救药物。吗啡组患者使用的补救性便秘药物最多(73%,n = 16/22)。结论:口服docusate钠并没有减少WPB VAHCS CLC患者对救急便秘药物的需求。当评估便秘治疗时,docusate钠可能提供最小的益处,可以确定为非必要的缓解努力。吗啡是该患者群体中使用最多的便秘阿片类药物,需要更积极的肠道治疗方案。
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