Adjusting Bowel Regimens When Prescribing Opioids in Women Receiving Palliative Care in the Acute Care Setting

Am J Hosp Palliat Care. 2016 Aug;33(7):663-8. doi: 10.1177/1049909115584754. Epub 2015 May 11.

Abstract

In palliative medicine, constipation is the third most common symptom after pain and anorexia, causing some patients to discontinue opioid therapy. Women experience higher incidence of constipation than men. The prevalence of infrequent bowel movements (<3 times/wk) and adherence to an established bowel regimen among women receiving opioids were studied. Referral to the palliative care team decreased the prevalence of infrequent bowel movements from 72% to 45%, and algorithm adherence increased from 38% to 78%. Education of oncology nurses decreased the prevalence of infrequent bowel movements among patients with cancer from 71% to 60%, and algorithm adherence increased from 0% to 10%. Patients benefit from stool softeners and stimulants when receiving opioids.

Keywords: acute care; bowel regimen; opioid-induced bowel dysfunction; palliative care; women.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / adverse effects*
  • Analgesics, Opioid / therapeutic use
  • Cancer Pain / drug therapy*
  • Cathartics / therapeutic use
  • Constipation / chemically induced*
  • Constipation / drug therapy
  • Female
  • Humans
  • Laxatives / therapeutic use
  • Middle Aged
  • Oncology Nursing / education*
  • Palliative Care / organization & administration*
  • Patient Care Team / organization & administration

Substances

  • Analgesics, Opioid
  • Cathartics
  • Laxatives