Prevalence and Risk Factors for Opioid-Induced Constipation in an Older National Veteran Cohort

Area of Science:

• Gastroenterology
• Pharmacology
• Epidemiology

Background:

• Opioid-induced constipation (OIC) is a common and distressing side effect of opioid therapy.
• Understanding the prevalence and risk factors for OIC is crucial for effective patient management.

Purpose of the Study:

• To determine the prevalence of OIC in a national veteran cohort.
• To identify covariates associated with the development of OIC.
• To explore potential modifiable factors for OIC risk stratification.

Main Methods:

• An observational cohort study of 152,904 veterans using integrated Center for Medicare and Medicaid Services (CMS) data.
• Opioid exposure was defined as 30 days or more with no prior exposure in the preceding year.
• OIC was identified via laxative prescription changes, constipation diagnoses, or related procedures.

Main Results:

• The prevalence of OIC was 12.6% in the studied veteran cohort.
• Positively associated covariates included prior constipation and prevalent laxative use.
• Negatively associated covariates included erythromycins, androgens/anabolics, and unknown race.

Conclusions:

• Novel covariates for OIC were identified, expanding on existing chronic constipation literature.
• Modifiable factors, such as medication coadministration, may aid in OIC risk stratification.
• The integration of CMS data highlights the elderly population as a key area for future OIC research.