Abstract 5556
Background
Patients with cancer under opioid treatment often develop opioid-induced constipation (OIC). Despite the high prevalence, medical management of OIC is often uncertain. This study sought to gather the opinion of experts in opioid use and OIC to reach a consensus on diagnosis and treatment strategies.
Methods
A modified Delphi method was conducted involving multidisciplinary experts. The resulting questionnaire addressed OIC diagnosis, OIC treatment, and quality of life of patients with cancer and OIC.
Results
A consensus in agreement was reached in almost all items (91%). Most of the panelists agreed that, although common (87.2%), the diagnosis of OIC in patients with cancer is difficult because of the limited knowledge of its pathophysiological features (80%). In patients with cancer, OIC control improves pain treatment adherence, which in turn improves their quality of life (95.7%). For effective diagnosis, experts recommend healthcare professionals to proactively ask patients under opioid treatment about the symptoms of OIC (100%). Occasionally, patients only report symptoms of OIC when these are severe (85.1%). Additionally, the experts recommended a complete patient’s clinical history (95.7%) with special focus on previous functional constipation (93.6%) that should be treated before opioid therapy begins (76.6%). For the specific treatment of OIC in patients with cancer most of the panelists agree that laxatives are not often effective (78.7%) and, according to clinical practice, it is recommended to take oral Peripherally Acting µ-Opioid Receptor Antagonists (PAMORAs; e.g. naloxegol) along with the prescribed laxative (80%). Furthermore, the management of OIC should start as soon as possible since the treatment is more complicated with stablished OIC and severe symptoms (95.7%). Regarding hygienic-dietary recommendations the panel agreed that, although necessary, they are not sufficiently effective (91.5%).
Conclusions
OIC needs to be specifically managed to improve the quality of life of patients with cancer. This modified Delphi consensus considered expert opinions in the search of therapeutic strategies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Kyowa Kirin Farmaceutica.
Funding
Kyowa Farmaceutica S.L.U. Spain.
Disclosure
R. Girones Sarrio: Advisory / Consultancy: Kyowa Kirin Farmaceutica; Advisory / Consultancy: Roche; Travel / Accommodation / Expenses: Sanofi; Advisory / Consultancy: Pfizer; Advisory / Consultancy: MSD. E. Falcó: Advisory / Consultancy: Kyowa Kirin Farmaceutica. A. Gozalvo: Advisory / Consultancy: Kyowa Kirin Farmaceutica. J.M. Esparza Miñana: Advisory / Consultancy: Kyowa Kirin Farmaceutica. A. Calsina-Berna: Advisory / Consultancy: Kyowa Kirin Farmaceutica. J. Porta Sales: Advisory / Consultancy: Kyowa Kirin Farmaceutica.
Resources from the same session
5553 - Cytokine genetic variations and worse quality of life among family caregivers of head and neck cancer patients in palliative care
Presenter: Daniel Pequeno
Session: Poster Display session 1
Resources:
Abstract
4321 - Health-related quality of life of advanced melanoma survivors treated with CTLA-4 immune checkpoint inhibition: a matched cohort study
Presenter: Annelies Boekhout
Session: Poster Display session 1
Resources:
Abstract
779 - Capecitabine vs Cisplatin along with concurrent radiotherapy in the treatment of inoperable lower esophageal cancers focusing on TWISTT score and QOL
Presenter: Goutham Anugu
Session: Poster Display session 1
Resources:
Abstract
5914 - Cancer, Mental Health and End Life Simulation (CAMhELS): A novel effectiveness evaluation.
Presenter: Asanga Fernando
Session: Poster Display session 1
Resources:
Abstract
2597 - Cancer patients’ expectations and understanding about their disease
Presenter: Mónica Pinho
Session: Poster Display session 1
Resources:
Abstract
5187 - Impact of patients’ death on oncologists and coping strategies: An online survey
Presenter: Soumaya Labidi
Session: Poster Display session 1
Resources:
Abstract
4579 - Clinical benefit from late lines of therapy offered to patients treated in a tertiary referral centre
Presenter: Andrea Sbrana
Session: Poster Display session 1
Resources:
Abstract
5058 - Preparedness for caregiving in caregivers of cancer patients
Presenter: Hatice Yakar
Session: Poster Display session 1
Resources:
Abstract
5917 - Oncologic Emergency Medicine in the real world: A survey and proposal for improvement
Presenter: Carintia Dorta Pérez
Session: Poster Display session 1
Resources:
Abstract
4077 - The Reality of Critical Cancer Patients in a Polyvalent Intensive Care Unit
Presenter: Tiago Filipe Da Cruz Tomas
Session: Poster Display session 1
Resources:
Abstract