title: Impact of constipation on opioid therapy management among long-term opioid users, based on a patient survey.
abstract: OBJECTIVE
  The authors sought to characterize health-related quality of life (HRQoL), medication adherence, productivity losses, and treatment satisfaction associated with modifications to opioid therapy due to opioid-induced constipation (OIC).
  
  
  METHODS
  A cross-sectional, between-subjects design was used to examine health outcomes among US noncancer participants currently taking opioids.
  
  
  METHODS
  Participants were adults in the 2012 US National Health and Wellness Survey, who reported currently using opioids (> 30 days) and experiencing constipation. Respondents were categorized as making modifications to opioid therapy due to OIC (modifiers, n = 244) or making no modifications (nonmodifiers, n = 247).
  
  
  METHODS
  Patient Assessment of Constipation Quality of Life (PAC-QoL) and Symptoms (PAC-Sym), Morisky Medication Adherence Scale (MMAS-4), Work Productivity and Activity Impairment, and the Treatment Satisfaction Questionnaire for Medication (TSQM II) for OIC treatment were administered. Generalized linear models were adjusted to control for baseline characteristics (age, gender, comorbidities, opioid strength, etc).
  
  
  RESULTS
  Modifiers reported poorer HRQoL (PAC-QoL total: 1.74 vs 1.44, p < 0.001), worse constipation (PAC-Sym total: 1.56 vs 1.35, p = 0.003), more pain-related resource use (surgery: odds ratio (OR) = 3.72, p = 0.002; emergency room visits: OR = 1.88, p = 0.049; hospitalizations: OR = 2.47, p = 0.033), and lower adherence (MMAS-4 pain: OR = 0.12, p < 0.001; MMAS-4 OIC: OR = 0.39, p < 0.001) than nonmodifiers. Modifiers reported greater presenteeism (49.75 percent vs 38.28 percent, p = 0.038), but no significant differences were found for activity impairment or OIC treatment satisfaction.
  
  
  CONCLUSIONS
  Treating OIC effectively may help prevent inadequate pain management secondary to opioid therapy modification, help increase HRQoL, lessen OIC symptoms, decrease productivity loss, and improve adherence to opioid and OIC treatments.
authors: Health Outcomes Practice, Kantar Health, Princeton, New Jersey.
authors: Shaloo
authors: S
authors: Gupta
authors: Consultant, Immensity Consulting, Inc., Chicago, Illinois.
authors: Haridarshan
authors: H
authors: Patel
authors: US Medical Affairs, Takeda Pharmaceuticals International, Inc., Deerfield, Illinois.
authors: Justin
authors: J
authors: Scopel
authors: Global Outcomes Research Department, Takeda Pharmaceuticals International, Inc., Deerfield, Illinois.
authors: Reema R
authors: RR
authors: Mody
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D003248:Constipation / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D059408:Pain Management / Q000379:methods / Q000706:statistics & numerical data; D010147:Pain Measurement; D017060:Patient Satisfaction; D011788:Quality of Life; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid