Opioid-Induced Constipation Among Patients with Chronic Noncancer Pain in the United States, Canada, Germany, and the United Kingdom: Laxative Use, Response, and Symptom Burden Over Time

PurposeEstimate rate of laxative inadequate response (LIR) over time among patients with chronic noncancer pain with opioid-induced constipation (OIC). MethodsA prospective longitudinal study was conducted in United States, Canada, Germany, and United Kingdom. Patients on opioid therapy for 4 weeks for chronic noncancer pain and OIC completed an Internet-based survey at Baseline and Weeks 2, 4, 6, 8, 12, 16, 20, and 24. 1xLIR was defined as sufficient laxative use (1 laxative4 times in past 2 weeks) and inadequate response (<3 bowel movements or1 constipation symptom rated Moderate or greater). 2xLIR was sufficient laxative use of 2 laxatives from different drug classes and inadequate response. Descriptive statistics and logistic regressions were performed. Results489 patients (62% female; 85% white) completed Baseline; 27% reported no laxative use; 25% had insufficient laxative use; 48% had sufficient laxative use. During follow-up, 21-28% of patients had no or insufficient laxative use. Prevalence of 1xLIR was 93% at Baseline and ranged from 59-81% across follow-up; 26% met criteria for 2xLIR (follow-up range: 11-20%). ConclusionsOIC among noncancer pain patients is a persistent and significant condition with varying utilization and response to laxatives thus increasing the ongoing burden of chronic pain. (c) 2014 Wiley Periodicals, Inc.