Laxative Utilization Over Time in Chronic Pain Patients with Opioid-Induced Constipation

Abstract

Aim: To determine laxative utilization over time among chronic noncancer pain patients with opioid-induced constipation (OIC). Setting: A prospective longitudinal study conducted in the USA, Canada, Germany and UK. Methods: Patients on daily opioid therapy for treatment of chronic noncancer pain with OIC were recruited from clinics to complete a survey at Baseline and weeks 2, 4, 6, 8, 12, 16, 20 and 24. Results: 489 patients completed baseline with 452 completing one or more follow-up visits. 128 (28%) were nonlaxative users, 112 (25%) were insufficient laxative users and 212 (47%) were sufficient laxative users. The consistent sufficient laxative users reported the most bowel movements per week. Conclusion: The majority of OIC patients do not take or only intermittently take laxatives.

KEYWORDS:

• constipation
• laxatives
• opioid
• pain
• symptoms

Acknowledgements

The authors would like to acknowledge the work of the following employees of UBC: an Express Scripts Company who contributed to the study design and implementation and to the data collection: KA Payne, C Valenzula, J Jean-Mary and A Goldwin. The authors would also like to acknowledge the work of the following Evidera employees who contributed to the data analysis: H Wilson and N Wu. The authors would also like to acknowledge the work of the following AstraZeneca employees who contributed to the study design and implementation: F King, S Chavoshi, R Dirienzi, B Alemayehu and J Crawley.

Author contributions

All authors participated in data analysis and interpretation, and contributed to the development of the manuscript. The authors maintained control over the final contents of the manuscript and the decision to publish.

Financial & competing interests disclosure

This study was funded by AstraZeneca. KS Coyne and C Thompson are employed by Evidera, which provides consulting and other research services to pharmaceutical, device, government and nongovernment organizations. As Evidera employees, they work with a variety of companies and organizations and are expressly prohibited from receiving any payment or honoraria directly from these organizations for services rendered. MK Margolis was employed by Evidera at the time the study was conducted and the manuscript completed. CJ Datto and RJ LoCasale are employed by AstraZeneca and may own AstraZeneca stock or stock options. KS Coyne, MK Margolis and C Thompson were paid consultants to AstraZeneca in connection with the development of this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate insti­tutional review board approval or have followed the princi­ples outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investi­gations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

This study was funded by AstraZeneca. KS Coyne and C Thompson are employed by Evidera, which provides consulting and other research services to pharmaceutical, device, government and nongovernment organizations. As Evidera employees, they work with a variety of companies and organizations and are expressly prohibited from receiving any payment or honoraria directly from these organizations for services rendered. MK Margolis was employed by Evidera at the time the study was conducted and the manuscript completed. CJ Datto and RJ LoCasale are employed by AstraZeneca and may own AstraZeneca stock or stock options. KS Coyne, MK Margolis and C Thompson were paid consultants to AstraZeneca in connection with the development of this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.