title: 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.
abstract: OBJECTIVE
  Estimate rate of laxative inadequate response (LIR) over time among patients with chronic noncancer pain with opioid-induced constipation (OIC).
  
  
  METHODS
  A 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 laxative ≥ 4 times in past 2 weeks) and inadequate response (<3 bowel movements or ≥ 1 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.
  
  
  RESULTS
  489 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%).
  
  
  CONCLUSIONS
  OIC 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. © 2014 Wiley Periodicals, Inc.
authors: Outcomes Research, Evidera, Bethesda, Maryland, USA.
authors: Karin S
authors: KS
authors: Coyne
authors: Outcomes Research, Evidera, Bethesda, Maryland, USA.
authors: Mary Kay
authors: MK
authors: Margolis
authors: Value Demonstration, United BioSource Corporation (UBC) An Express Scripts Company, Montreal, Quebec, Canada.
authors: Karen
authors: K
authors: Yeomans
authors: Global Payer Evidence and Pricing in Global Medicines and Development, AstraZeneca, Gaithersburg, Maryland, USA.
authors: Frederic R
authors: FR
authors: King
authors: Medical Evidence in Global Medical Affairs, AstraZeneca, Gaithersburg, Maryland, USA.
authors: Soheil
authors: S
authors: Chavoshi
authors: Value Demonstration, United BioSource Corporation (UBC) An Express Scripts Company, Montreal, Quebec, Canada.
authors: Krista A
authors: KA
authors: Payne
authors: Medical Evidence & Observational Research in Global Medical Affairs AstraZeneca, Gaithersburg, Maryland, USA.
authors: Robert J
authors: RJ
authors: LoCasale
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D002170:Canada / Q000453:epidemiology; D059350:Chronic Pain / Q000139:chemically induced* / Q000188:drug therapy*; D003248:Constipation / Q000139:chemically induced* / Q000453:epidemiology*; D017281:Cost of Illness; D004363:Drug Utilization; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D054368:Laxatives
keywords: Constipation; Laxatives; Opioid; Pain; Symptoms