title: Adjusting Bowel Regimens When Prescribing Opioids in Women Receiving Palliative Care in the Acute Care Setting.
abstract: In palliative medicine, constipation is the third most common symptom after pain and anorexia, causing some patients to discontinue opioid therapy. Women experience higher incidence of constipation than men. The prevalence of infrequent bowel movements (<3 times/wk) and adherence to an established bowel regimen among women receiving opioids were studied. Referral to the palliative care team decreased the prevalence of infrequent bowel movements from 72% to 45%, and algorithm adherence increased from 38% to 78%. Education of oncology nurses decreased the prevalence of infrequent bowel movements among patients with cancer from 71% to 60%, and algorithm adherence increased from 0% to 10%. Patients benefit from stool softeners and stimulants when receiving opioids.
authors.affiliation: Hahn School of Nursing and Health Science, Betty and Bob Beyster Institute for Nursing Research, Advanced Practice and Simulation, University of San Diego, San Diego, CA, USA lgonzales@sandiego.edu.
authors.forename: Lucia K
authors.initials: LK
authors.lastname: Gonzales
authors.affiliation: Palliative Care Team, St Joseph Hospital, Orange, CA, USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Delmastro
authors.affiliation: Oncology Unit, St Joseph Hospital, Orange, CA, USA.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Boyd
authors.affiliation: Palliative Care Team, St Joseph Hospital, Orange, CA, USA.
authors.forename: Melvyn L
authors.initials: ML
authors.lastname: Sterling
authors.affiliation: Education and Research Department, St Joseph Hospital, Orange, CA, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Aube
authors.affiliation: Palliative Care Team, St Joseph Hospital, Orange, CA, USA.
authors.forename: Rosemary N
authors.initials: RN
authors.lastname: Le
authors.affiliation: Palliative Care Team, St Joseph Hospital, Orange, CA, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Traucht
authors.affiliation: Oncology Unit, St Joseph Hospital, Orange, CA, USA.
authors.forename: Leonida R
authors.initials: LR
authors.lastname: Quinal
authors.affiliation: Hahn School of Nursing and Health Science, Betty and Bob Beyster Institute for Nursing Research, Advanced Practice and Simulation, University of San Diego, San Diego, CA, USA.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Georges
authors.affiliation: Hahn School of Nursing and Health Science, Betty and Bob Beyster Institute for Nursing Research, Advanced Practice and Simulation, University of San Diego, San Diego, CA, USA.
authors.forename: Dale N
authors.initials: DN
authors.lastname: Glaser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D000072716:Cancer Pain / Q000188:drug therapy*; D002400:Cathartics / Q000627:therapeutic use; D003248:Constipation / Q000139:chemically induced* / Q000188:drug therapy; D005260:Female; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D008875:Middle Aged; D009859:Oncology Nursing / Q000193:education*; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration
chemical_list: D000701:Analgesics, Opioid; D002400:Cathartics; D054368:Laxatives
keywords: acute care; bowel regimen; opioid-induced bowel dysfunction; palliative care; women