What to Do and What Not to Do in the Management of Opioid-Induced Constipation: A Choosing Wisely Report.
Pain Ther
; 9(2): 657-667, 2020 Dec.
Article
em En
| MEDLINE
| ID: mdl-32940898
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Guideline
/
Prognostic_studies
Idioma:
En
Revista:
Pain Ther
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Itália