Pharmacological and rehabilitation strategies in opioid-induced constipation: an observational study

Research on the combined effects of Naldemedine and targeted rehabilitation for managing opioid-induced constipation (OIC) is limited. This retrospective study aims to explore their use in chronic pain patients with OIC.

The study examined 53 patients with OIC, comparing outcomes between those receiving Naldemedine with targeted physical exercise (28 in Naldemedine + Rehabilitation group) and those receiving Naldemedine alone (25 in Naldemedine alone group). Assessments at baseline (T0), 14 ± 2 days (T1), and three months (T2) included Numerical Rating Scale (NRS), Patient Assessment of Constipation Quality of Life (PAC-QoL) and Bowel Function Index (BFI).

Combining Naldemedine with rehabilitation led to higher patient satisfaction at three months compared to Naldemedine alone, while no significant between-group differences were observed in abdominal pain relief or bowel function. After 14 days of treatment, both groups demonstrated improvements in NRS, BFI, PAC-QoL total score, and PAC-QoL subscale for satisfaction (p = 0.716, p = 0.886, p = 0.585, p = 0.431). After three-month, Naldemedine + Rehabilitation group showed significantly higher satisfaction levels compared to those on Naldemedine alone, as indicated by PAC-QoL total score and sub-score for satisfaction (p = 0.031, p = 0.0163).

The implementation of a combined approach involving targeted physical exercise alongside Naldemedine treatment showed promising results in enhancing patients' satisfaction.