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Opioid-induced constipation in patients with cancer pain in Japan (OIC-J study): a post hoc subgroup analysis of patients with lung cancer.

日本癌症疼痛患者阿片类药物引起的便秘 (OIC-J研究): 肺癌患者的事后亚组分析。

  • 影响因子:2.04
  • DOI:10.1093/jjco/hyaa186
  • 作者列表:"Imai H","Fumita S","Harada T","Noriyuki T","Gamoh M","Okamoto M","Akashi Y","Kizawa Y","Tokoro A
  • 发表时间:2021-03-03
Abstract

OBJECTIVE:To evaluate the opioid-induced constipation burden in the subgroup of patients with lung cancer who participated in the observational Opioid-Induced Constipation in Patients with Cancer Pain in Japan (OIC-J) study. METHODS:The prospective, observational study, OIC-J, included 212 patients with various tumour types, 33% of whom had lung cancer. The incidence of opioid-induced constipation was evaluated using several diagnostic criteria, as well as the physician's diagnosis and patient's subjective assessment. Following initiation of opioids, patients recorded details of bowel movements (i.e. date/time, Bristol Stool Scale form, sensations of incomplete evacuation or anorectal obstruction/blockage and degree of straining) in a diary for 2 weeks. Relationships between patient characteristics and opioid-induced constipation onset and effects of opioid-induced constipation on quality of life were explored. RESULTS:In total, 69 patients were included in this post hoc analysis. The incidence of opioid-induced constipation varied (39.1-59.1%) depending on which diagnostic criteria was used. Diagnostic criteria that included a quality component or a patient's feeling of bowel movement as an evaluation item (i.e. Rome IV, physician's diagnosis, Bowel Function Index, patient's assessment) showed higher incidences of opioid-induced constipation than recording the number of spontaneous bowel movements alone. Opioid-induced constipation occurred rapidly after initiating opioids and had a significant impact on Patient Assessment of Constipation Symptoms total score (P = 0.0031). Patient baseline characteristics did not appear to be predictive of opioid-induced constipation onset. CONCLUSIONS:In patients with lung cancer, opioid-induced constipation can occur quickly after initiating opioids and can negatively impact quality of life. Early management of opioid-induced constipation, with a focus on quality-of-life improvement and patient's assessments of bowel movements, is important for these patients.

摘要

目的: 评估参与日本癌性疼痛患者阿片类药物引起便秘观察 (OIC-J) 研究的肺癌患者亚组中阿片类药物引起的便秘负担。 方法: 前瞻性,观察性研究,OIC-J,包括212例不同肿瘤类型的患者,其中33% 患有肺癌。使用几种诊断标准以及医生的诊断和患者的主观评估来评估阿片类药物诱导的便秘的发生率。在开始使用阿片类药物后,患者记录了排便的细节 (即日期/时间,布里斯托尔粪便量表形式,不完全排空或肛门直肠阻塞/堵塞的感觉和应变程度) 在日记中持续2周。探讨患者特征与阿片类药物引起的便秘发病之间的关系以及阿片类药物引起的便秘对生活质量的影响。 结果: 共有69例患者纳入本事后分析。阿片类药物引起的便秘的发生率根据使用的诊断标准而变化 (39.1-59.1%)。包括质量成分或患者的排便感觉作为评价项目的诊断标准 (即Rome IV,医生的诊断,肠功能指数,患者的评估) 显示阿片类药物引起的便秘的发生率高于单独记录自发排便次数。阿片类药物引起的便秘在开始使用阿片类药物后迅速发生,并对患者评估便秘症状总分有显著影响 (P = 0.0031)。患者基线特征似乎不能预测阿片类药物诱导的便秘发作。 结论: 在肺癌患者中,阿片类药物引起的便秘可在开始使用阿片类药物后迅速发生,并可对生活质量产生负面影响。阿片类药物引起的便秘的早期管理,重点是生活质量的改善和患者对排便的评估,对这些患者很重要。

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发表时间:2021-02-01
DOI:10.1080/14656566.2020.1814255
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发表时间:2021-03-24
DOI:10.1007/s11033-021-06299-9
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