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Poster Display session 1

5004 - Clinical practice evaluation of opioids induced constipation management in cancer patients: The EIO-Praxis project.

Date

28 Sep 2019

Session

Poster Display session 1

Topics

Supportive Care and Symptom Management

Tumour Site

Presenters

Enrique Aranda Aguilar

Citation

Annals of Oncology (2019) 30 (suppl_5): v718-v746. 10.1093/annonc/mdz265

Authors

E. Aranda Aguilar1, J. Garcia Foncillas2, A. Antón3, C.J. Camps Herrero4, A. Carrato Mena5, M. Constenla Figueiras6, J.J. Cruz Hernandez7, E. Diaz Rubio8, P.N. Gascon9, V. Guillem Porta10, R. López11, M. Feyjóo12, J. Puente13

Author affiliations

  • 1 Medical Oncology, Fundación ECO, Hospital Reina Sofía de Córdoba, 14004 - Cordoba/ES
  • 2 Medical Oncology, Fundación ECO, Fundación Jiménez Díaz, 28040 - Madrid/ES
  • 3 Medical Oncology, Fundación ECO, Hospital Universitario Miguel Servet, 50009 - Zaragoza/ES
  • 4 Medical Oncology, Fundación ECO, Hospital General de Valencia, Universidad de Valencia, CIBERONC, 46014 - Valencia/ES
  • 5 Medical Oncology, Fundación ECO, Hospital Ramón y Cajal, IRYCIS, CIBERONC, Universidad de Alcala, 28031 - Madrid/ES
  • 6 Medical Oncology, Fundación ECO, Complejo Hospitalario Universitario Pontevedra, 36001 - Pontevedra/ES
  • 7 Medical Oncology, Fundación ECO, Hospital Clínico Universitario de Salamanca, 37007 - Salamanca/ES
  • 8 Vice-presidency, Fundación ECO, Real Academia Nacional de Medicina, IdISCC, CIBERONC, 28013 - Madrid/ES
  • 9 Medical Oncology, Fundación ECO, Hospital Universitario Clinic, 08036 - Barcelona/ES
  • 10 Medical Oncology, Fundación ECO, Instituto Valenciano de Oncología, 46009 - Valencia/ES
  • 11 Medical Oncology, Fundación ECO, Hospital Clínico Universitario de Santiago de Compostela, 15706 - Santiago de Compostela/ES
  • 12 Medical Oncology, Fundación ECO, Hospital Universitario La Moraleja Sanitas, 28050 - Madrid/ES
  • 13 Medical Oncology, Fundación ECO, Hospital Clínico San Carlos, 28040 - Madrid/ES

Resources

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Abstract 5004

Background

In 2017, the ECO Foundation (Excellence and Quality in Oncology) completed the EIO-50 project to learn about the diagnostic and treatment criteria of opioid-induced constipation (OIC) in cancer patients. The EIO-Praxis project was designed as a continuation of EIO-50, to learn about the current clinical practice of oncology professionals for the management of patients with OIC (process, follow-up and results).

Methods

77 health care professionals (HCP) from oncology units participated in the study. Each investigator collected information from 10 medical records of cancer patients who received OIC treatment, with a total of 770 records. In each center, 6 indicators of its structure were collected and the completion of a questionnaire with 15 questions regarding patient’s follow-up and treatment process was conducted.

Results

According to healthcare professionals (HCP), an average proportion of 47.5% of cancer patients received treatment with opioids. From these, an average of 44.9% developed OIC. 51.9% of the investigators didn’t follow any guidelines for the management of patients with OIC. The mean age of the patients of the study was 61.6 years old. The mean duration of opioid treatment was 4.9 months, with an average time of 16.5 days from the start of opioid treatment to the appearance of the first symptoms of OIC. Only in 55.1% of the patients, the presence of functional constipation before starting opioid treatment was assessed. Patients of the study presented the following Rome IV criteria symptoms: 82.6% reduced bowel frequency, 52.9% fewer than three spontaneous bowel movements per week, 54.4% development or worsening of straining and stool consistency (54.2%). The majority of the patients were treated with laxatives (76.0%). Oral Peripherally Active µ-Opioid Receptor Antagonist (PAMORA) was also used in 54.8% of the patients.

Conclusions

Despite new guidelines for the management of constipation in cancer patients were published in 2018, the management of OIC is still insufficient. After laxative failures, the use of PAMORA drugs should be taken into consideration for the management of OIC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

ECO Foundation.

Funding

Kyowa Kirin.

Disclosure

E. Aranda Aguilar: Advisory / Consultancy: Amgen; Advisory / Consultancy: Bayer; Advisory / Consultancy: Celgene; Advisory / Consultancy: Merck; Advisory / Consultancy: Roche; Advisory / Consultancy: Sanofi. J. Garcia Foncillas: Advisory / Consultancy, Travel / Accommodation / Expenses: Roche; Advisory / Consultancy: Bayer; Advisory / Consultancy, Travel / Accommodation / Expenses: Sanofi; Research grant / Funding (institution): Merck. E. Diaz Rubio: Advisory / Consultancy, Research grant / Funding (institution): Amgen; Advisory / Consultancy: Bayer; Advisory / Consultancy: Genomica; Advisory / Consultancy, Speaker Bureau / Expert testimony: Servier; Advisory / Consultancy, Research grant / Funding (institution): Merck Serono; Speaker Bureau / Expert testimony: MSD; Research grant / Funding (institution): Roche; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Sysmex. R. López: Shareholder / Stockholder / Stock options, Licensing / Royalties: Nasasbiotech; Shareholder / Stockholder / Stock options: Mtrap Inc; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: Roche; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution): Merck; Advisory / Consultancy: MSD; Advisory / Consultancy: Bayer; Advisory / Consultancy, Travel / Accommodation / Expenses: BMS; Advisory / Consultancy: Novartis; Advisory / Consultancy: Janssen; Advisory / Consultancy: Lilly; Advisory / Consultancy: Pfizer; Travel / Accommodation / Expenses: PharmaMar; Travel / Accommodation / Expenses: Pierre Fabre. All other authors have declared no conflicts of interest.

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