Opioid-induced constipation in patients with cancer pain in Japan (OIC-J study): a post hoc subgroup analysis of patients with lung cancer.

Abstract

OBJECTIVE:

To evaluate the opioid-induced constipation burden in the subgroup of patients with lung cancer who participated in the observational Opioid-Induced Constipation in Patients with Cancer Pain in Japan (OIC-J) study.

METHODS:

The prospective, observational study, OIC-J, included 212 patients with various tumour types, 33% of whom had lung cancer. The incidence of opioid-induced constipation was evaluated using several diagnostic criteria, as well as the physician's diagnosis and patient's subjective assessment. Following initiation of opioids, patients recorded details of bowel movements (i.e. date/time, Bristol Stool Scale form, sensations of incomplete evacuation or anorectal obstruction/blockage and degree of straining) in a diary for 2 weeks. Relationships between patient characteristics and opioid-induced constipation onset and effects of opioid-induced constipation on quality of life were explored.

RESULTS:

In total, 69 patients were included in this post hoc analysis. The incidence of opioid-induced constipation varied (39.1-59.1%) depending on which diagnostic criteria was used. Diagnostic criteria that included a quality component or a patient's feeling of bowel movement as an evaluation item (i.e. Rome IV, physician's diagnosis, Bowel Function Index, patient's assessment) showed higher incidences of opioid-induced constipation than recording the number of spontaneous bowel movements alone. Opioid-induced constipation occurred rapidly after initiating opioids and had a significant impact on Patient Assessment of Constipation Symptoms total score (P = 0.0031). Patient baseline characteristics did not appear to be predictive of opioid-induced constipation onset.

CONCLUSIONS:

In patients with lung cancer, opioid-induced constipation can occur quickly after initiating opioids and can negatively impact quality of life. Early management of opioid-induced constipation, with a focus on quality-of-life improvement and patient's assessments of bowel movements, is important for these patients.

• Authors: Hisao Imai, Soichi Fumita, Toshiyuki Harada, Toshio Noriyuki, Makio Gamoh, Masaharu Okamoto, Yusaku Akashi, Yoshiyuki Kizawa, Akihiro Tokoro
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 51 Issue 3 Pg. 444-450 (Mar 03 2021) ISSN: 1465-3621 [Electronic] England
• PMID: 33157554 (Publication Type: Journal Article, Observational Study)
• Copyright: © The Author(s) 2020. Published by Oxford University Press.

Topics

• Adult
• Aged
• Cancer Pain (complications, drug therapy)
• Female
• Humans
• Incidence
• Japan (epidemiology)
• Kaplan-Meier Estimate
• Lung Neoplasms (complications, drug therapy)
• Male
• Middle Aged
• Opioid-Induced Constipation (complications, epidemiology)
• Prospective Studies
• Quality of Life