Abstract 1871P
Background
Opioid-induced constipation (OIC) is a common adverse effect of opioid therapy. Despite the development of guidelines, its management is not always adequate. We aim to identify the main barriers hindering clinical recommendations implementation and propose consensus solutions.
Methods
Following collaborative and prioritization techniques, a scientific committee generated statements addressing possible barriers to optimal OIC management (related to patients, health providers and health care system), and potential interventions to overcome these barriers. An expert panel of 36 oncologists assessed the statements using a nine-point ordinal scale (1=full disagreement, 9=full agreement). Agreement consensus on a statement was reached when the responses’ median was included within the 7-9 category and less of 1/3 of the respondents voted outside this range.
Results
The survey consisted of 70 statements. Consensus was reached on 12 out of 45 items related to barriers (26.6%) and on 19 out of 25 items about corrective interventions (76%). The panel considered that patients are unaware of the existence of a specific EIO treatment, and their information sources are highly variable and unreliable. Regarding health providers, the panel considered that the oncologists prioritize symptoms such as diarrhoea, pain, anxiety or other treatment toxicities, over constipation. Work overload and bureaucratic requirements were the main barriers related to health care system. Regarding potential interventions, best-rated proposals included specific training programs development for primary care physicians and nurses, and multiplatform informative resources development for patients and caregivers, including precise written instructions about OIC recognition and management. Considering good clinical practice habits, oncologists assessed positively measures aiming to improve coordination between primary care physicians and oncologists, and nursing consultations implementation. The panel considered useful the OIC treatment algorithms simplification.
Conclusions
An expert panel identified the main barriers to optimal OIC management and suggested some feasible approaches to overcome these barriers.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Kyowa Kirin S.L.U.
Funding
Kyowa Kirin S.L.U.
Disclosure
All authors have declared no conflicts of interest.