title: Assessment of a Stool Symptom Screener and Understanding the Opioid-Induced Constipation Symptom Experience.
abstract: BACKGROUND
  Many patients with chronic opioid-induced constipation (OIC) seek treatment to relieve their symptoms. A symptom screener may be useful in identifying symptomatic OIC patients.
  
  
  OBJECTIVE
  The aims of this study were to assess patient understanding of Stool Symptom Screener content and to evaluate how patients described their constipation experience, to better understand the relationship between constipation symptoms and patterns of laxative use.
  
  
  METHODS
  Adult OIC patients were recruited through five clinical sites across the USA. Patients were classified as either frequent or non-frequent laxative users. Patients participated in a semi-structured interview to assess their understanding of a Stool Symptom Screener and to discuss their constipation symptoms and laxative use experience. Interview transcripts were reviewed using content analysis. Descriptive statistics were used to characterize the sample.
  
  
  RESULTS
  Sixty-six OIC patients participated: 39 frequent laxative users (mean age 53.3 years) and 27 non-frequent laxative users (mean age 55.5 years). Both patient groups described high levels of symptom burden on the Stool Symptom Screener as well as anecdotally. Both patient groups generally understood the Stool Symptom Screener items and felt the questions were relevant to their symptom experience. Most (95.5%) reported that they could remember their constipation symptoms "easily" over the previous 2 weeks. No qualitative differences were found between frequent and non-frequent laxative users in how they described their OIC symptom experience.
  
  
  CONCLUSIONS
  OIC patients understood this Stool Symptom Screener, and its content was relevant to this highly symptomatic patient sample. Pain and bloating may be considered as additional symptoms for future versions of the screener. An emerging conceptual model of the OIC experience, laxative use, and symptoms is presented.
authors.affiliation: Evidera, Outcomes Research, 7101 Wisconsin Avenue, Suite 600 Bethesda, MD, 20814, USA, karin.coyne@evidera.com.
authors.forename: Karin S
authors.initials: KS
authors.lastname: Coyne
authors.forename: Brooke M
authors.initials: BM
authors.lastname: Currie
authors.forename: William C
authors.initials: WC
authors.lastname: Holmes
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Crawley
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D002908:Chronic Disease; D003248:Constipation / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D000701:Analgesics, Opioid; D054368:Laxatives