Laxative co-medication and changes in defecation patterns during opioid use.

Area of Science:

• Pharmacology
• Gastroenterology
• Clinical Pharmacy

Background:

• Opioid-induced constipation (OIC) is a significant adverse effect of opioid therapy.
• OIC can lead to hospital admissions, increasing healthcare costs.

Purpose of the Study:

• To assess the use of laxative co-medication in patients initiating opioid therapy.
• To identify reasons for the absence of laxative prescriptions.
• To evaluate changes in bowel patterns among new opioid users.

Main Methods:

• An observational study involving community pharmacists.
• Pharmacists recorded laxative co-medication and reasons for non-use in opioid initiators.
• Patients completed validated questionnaires on stool form and functional gastrointestinal disorders before and during opioid use.

Main Results:

• 74.8% of 460 opioid initiators received concomitant laxatives.
• The primary reason for not using laxatives was a lack of perceived necessity by prescribers or patients.
• Constipation prevalence doubled during opioid use, affecting 16% of opioid starters without initial constipation.

Conclusions:

• A significant proportion of opioid starters (25%) do not receive laxative co-medication.
• The incidence of constipation increases substantially with opioid initiation.
• Monitoring bowel patterns using validated tools is recommended for managing OIC.