| Title: |
What to Do and What Not to Do in the Management of Opioid-Induced Constipation: A Choosing Wisely Report |
| Authors: |
Alvaro D.; Caraceni A.; Coluzzi F.; Gianni W.; Lugoboni F.; Marinangeli F.; Massazza G.; Pinto C.; Varrassi G. |
| Contributors: |
D. Alvaro; A. Caraceni; F. Coluzzi; W. Gianni; F. Lugoboni; F. Marinangeli; G. Massazza; C. Pinto; G. Varrassi |
| Publisher Information: |
Adis |
| Publication Year: |
2020 |
| Collection: |
The University of Milan: Archivio Istituzionale della Ricerca (AIR) |
| Subject Terms: |
Bristol Stool Scale; Chronic constipation; Opioid-induced constipation; Peripheral mu-opioid receptor antagonist; Rome IV criteria; Settore MED/06 - Oncologia Medica; Settore MED/09 - Medicina Interna |
| Description: |
Introduction: Despite the essential utility of opioids for the clinical management of pain, opioid-induced constipation (OIC) remains an important obstacle in clinical practice. In patients, OIC hinders treatment compliance and has negative effects on quality of life. From a clinician perspective, the diagnosis and management of OIC are hampered by the absence of a clear, universal diagnostic definition across disciplines and a lack of standardization in OIC treatment and assessment. Methods: A multidisciplinary panel of physician experts who treat OIC was assembled to identify a list of ten corrective actions—five “things to do” and five “things not to do”—for the diagnosis and management of OIC, utilizing the Choosing Wisely methodology. Results: The final list of corrective actions to improve the diagnosis and clinical management of OIC emphasized a need for: (i) better physician and patient education regarding OIC; (ii) systematic use of diagnostically validated approaches to OIC diagnosis and assessment (i.e., Rome IV criteria and Bristol Stool Scale, respectively) across various medical contexts; and (iii) awareness about appropriate, evidence-based treatments for OIC including available peripheral mu-opioid receptor antagonists (PAMORAs). Conclusions: Physicians who prescribe long-term opioids should be forthcoming with patients about the possibility of OIC and be adequately versed in the most recent guideline recommendations for its management. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/32940898; info:eu-repo/semantics/altIdentifier/wos/WOS:000570468100002; volume:9; issue:2; firstpage:657; lastpage:667; numberofpages:11; journal:PAIN AND THERAPY; https://hdl.handle.net/2434/909130 |
| DOI: |
10.1007/s40122-020-00195-z |
| Availability: |
https://hdl.handle.net/2434/909130; https://doi.org/10.1007/s40122-020-00195-z |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.655A82CA |
| Database: |
BASE |