'Constipation': One word, many meanings amongst persons with cancer: An observational study.

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Palliative Medicine Pub Date : 2025-03-12 DOI:10.1177/02692163251325711

Andrew Davies, Norah Fagan, Jenny Power, Amy Taylor

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引用次数: 0

Abstract

Background: Constipation is common in people with advanced cancer and is associated with significant morbidity and health economic burden, but it is often sub-optimally managed. Despite international consensus diagnostic criteria for functional and opioid-induced constipation (Rome IV diagnostic criteria), the term 'constipation' means different things to different people, impacting assessment, diagnosis and management.

Aim: To investigate the association between persons with advanced cancer self-reporting of constipation, response to the Rome IV diagnostic criteria statements for opioid-induced constipation and differences according to personal demographics.

Design: Multicentre prospective observational study.

Setting/participants: Twenty-four community, hospice and hospital research sites in 10 European countries recruited 1200 adults with cancer taking opioids for cancer/cancer-treatment related pain.

Results: In response to the simple question 'Are you constipated?', 549 (45.5%) participants replied 'yes', 588 (49%) replied 'no' and 59 (5%) were 'unsure', but 713 (59.5%) participants met the Rome IV diagnostic criteria. Only 439 (61.5%) participants that met these criteria answered the simple question positively, whilst 230 (39%) answered negatively, although there was a statistically significant association between responses to the simple question and the criteria (χ²(1, N = 1136) = 149.945, p = 0.00001). There were certain significant differences in self-reporting according to age and country of origin.

Conclusions: There is disparity between patients' self-reporting of constipation and the Rome IV diagnostic criteria. People with advanced cancer, especially those receiving opioid analgesics, need to be regularly assessed for constipation, but the use of a single question ('Are you constipated?') is inadequate.Registry: European Study of Opioid Induced Constipation (E-StOIC), NCT05149833, https://clinicaltrials.gov/study/NCT05149833, 08/12/2021.

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来源期刊

Palliative Medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

9.10%

发文量

125

审稿时长

6-12 weeks

期刊介绍： Palliative Medicine is a highly ranked, peer reviewed scholarly journal dedicated to improving knowledge and clinical practice in the palliative care of patients with far advanced disease. This outstanding journal features editorials, original papers, review articles, case reports, correspondence and book reviews. Essential reading for all members of the palliative care team. This journal is a member of the Committee on Publication Ethics (COPE).