Through Your Patient’s Eyes™ - Comprehensive Relief from Cancer Pain: Expanding the Conversation on Opioid-Induced Constipation

Despite a growing number of specific treatment options, many patients with cancer pain still suffer from opioid-induced constipation (OIC).1-3 Open communication among patients, caregivers, and treating clinicians is essential to determine the severity and psychosocial consequences of OIC.1-4 Patients with cancer pain and their proxies, however, are often reluctant to discuss opioid-related gastrointestinal symptoms and effects on quality of life. To address this barrier, clinicians should provide upfront education on the signs and symptoms of OIC, monitor bowel patterns at baseline and each subsequent visit, and use validated assessment tools to document changes in bowel habits.5,6 Monitoring can inform clinical decisions about escalating OIC treatment, including the introduction of mechanism-based therapies into bowl regimens.5,7 Shared clinical decision making that addresses patient preferences for OIC management (eg, oral vs subcutaneous administration of medication) is also critical.8,9 A patient-centric approach has been shown to improve clinical outcomes, satisfaction with care, and adherence to the ongoing treatment plan.10 This Through the Patient’s Eyes™ Webcast has been designed to educate oncology NPs, PAs, nurses, and other healthcare providers on proactively dialoging with oncology patients about OIC risks, longitudinally monitoring these individuals for opioid-related gastrointestinal issues, and properly advocating for bowel regimens that reduce the burdens of OIC.

References

1. Whitman CB, et al. Balancing opioid-induced gastrointestinal side effects with pain management: Insights from the online community. J Opioid Manag. 2015;11(5):383-391.

2. Panchal SJ, et al. Opioid-induced bowel dysfunction: prevalence, pathophysiology and burden. Int J Clin Pract. 2007;61(7):1181-1187.

3. Villars P. et al. Differences in the prevalence and severity of side effects based on type of analgesic prescription in patients with chronic cancer pain. J Pain Symptom Manage. 2007;33(1):67-77.

4. Bell TJ, et al. The prevalence, severity, and impact of opioid-induced bowel dysfunction: results of a US and European Patient Survey (PROBE 1). Pain Med. 2009;10(1);35-42.

5. Argoff CE, et al. Consensus recommendations on initiating prescription therapies for opioid-induced constipation. Pain Med. 2015;16(12):2324-2337.

6. Rentz AM, et al. Validation of the Bowel Function Index to detect clinically meaningful changes in opioid-induced constipation. J Med Econ. 2009;12(4):371-283.

7. Streicher JM, Bilsky EJ. Peripherally acting µ-opioid receptor antagonists for the treatment of opioid-related side effects: Mechanism of action and clinical implications. J Pharm Pract. 2017 Jan 1. [Epub ahead of print].

8. Lee J, et al. What are the patient factors affecting repetitive use of injectable pain relievers in outpatient care settings? Int J Clin Pharmacol Ther. 2014;52(3):202-208.

9. Anantharamu T, et al. Naloxegol: First oral peripherally acting mu opioid receptor antagonists for opioid-induced constipation. J Pharmacol Pharmacother. 2015;6(3):188-192.

10. Joosten EA, et al. Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychother Psychosom. 2008;77(4):219-226.