Cancer Constipation: Clinical Summary of the ONS Guidelines™ for Opioid-Induced and Non–Opioid-Related Cancer Constipation

LeFebvre, Kristine B.; Rogers, Barbara; Wolles, Brenda

doi:10.1188/20.cjon.685-688

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…One study focused specifically on the management of constipation in children in concurrent care management versus standard hospice care 19 . Eight of the 11 studies focused on cancer, or advanced cancer, and constipation 2,8,12-15,18,21 …”

Section: Resultsmentioning

confidence: 99%

“…LeFebvre et al 18 (2020) provided a clinical summary of the Oncology Nursing Society (ONS) Guidelines published in 2020 on opioid-induced and non–opioid-related cancer constipation. The recommendations from the Palliative Care Study Group of the Multinational Association of Supportive Care in Cancer on the management of constipation in patients with advanced cancer were included in this review.…”

Section: Resultsmentioning

confidence: 99%

Section: Established Guidelines Reviewedmentioning

confidence: 99%

“…Two studies provided evidence of clinical practice guidelines: the ONS and the Palliative Care Study Group of the Multinational Association of Supportive Care in Cancer 14,18 . LeFebvre et al 18 (2020) summarized ONS Guidelines on managing OIC and non–opioid-related constipation. Assessment, prevention, and treatment were key areas discussed, along with the strength of the recommendation and certainty of the evidence provided.…”

Section: Established Guidelines Reviewedmentioning

confidence: 99%

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A Rapid Review on the Management of Constipation for Hospice and Palliative Care Patients

Gill,

Badrzadeh,

Williams

et al. 2024

J Hosp Palliat Nurs

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Constipation is a distressing symptom that has a high prevalence in patients receiving hospice and palliative care services, particularly in cases of opioid use. A thorough assessment, root cause analysis, monitoring, and prophylactic approach are essential for symptom management and quality of life. This rapid review assessed studies published between 2018 and 2023 to identify strategies implemented by health care professionals to prevent and/or mitigate this distressing symptom. We identified 12 articles that addressed constipation in palliative and end-of-life settings and reported on the need for multifactorial management approaches with a focus on patient-centered care that includes the caregiver(s). Bedside nurses play a key role in assessing, identifying, and managing constipation. Proper documentation and communication with the interdisciplinary team help direct earlier intervention and ongoing awareness of constipation issues. Additional research is needed on specific tools and enhanced guidelines to ensure constipation is frequently addressed and preemptively managed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Established Guidelines Reviewedmentioning

confidence: 99%

Section: Established Guidelines Reviewedmentioning

confidence: 99%

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A Rapid Review on the Management of Constipation for Hospice and Palliative Care Patients

Gill,

Badrzadeh,

Williams

et al. 2024

J Hosp Palliat Nurs

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“…Another reason mentioned was that the patient is not capable of swallowing a laxative. This is most often the case in palliative patients who can especially benefit from a laxative [ 33 ]. Furthermore, GPs mentioned they start with a low dose of an opioid assuming the risk of constipation declines with reduction of the dose.…”

Section: Discussionmentioning

confidence: 99%

Adherence to coprescribing of laxatives with opioids and associated characteristics in general practices in the Netherlands

et al. 2022

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Background Guidelines recommend to prescribe a laxative with an opioid to prevent constipation. We aimed to determine the adherence by general practitioners (GPs) to this recommendation and to explore which GP- and patient related factors were associated with it from the perspective of the GP. Methods We conducted an observational study using GPs’ prescription data from the Nivel Primary Care Database combined with a questionnaire asking for reasons of non-adherence. The proportion of first opioid prescriptions prescribed together with a laxative was determined as primary outcome. Possible explanatory factors such as the quality of registration, the level of collaboration with the pharmacy, familiarity with the recommendation and use of a clinical decision support system were explored, as were the self-reported reasons for non-adherence (classified as either GP-related or patient-related). We assessed the association of factors with the primary outcome using univariable multilevel logistic regression analysis. Results The recommendation was measured in 195 general practices. The median proportion of first opioid prescriptions prescribed together with a laxative in these practices was 54% (practice range 18–88%). None of the determinants was consistently associated with the primary outcome. GPs from 211 practices filled out the questionnaire and the most frequently mentioned reason not to prescribe a laxative was that the patient has laxatives in stock, followed by that the patient doesn’t want a laxative; both were patient-related factors. Conclusion There was room for improvement in following the guideline on laxative prescribing in opioid use. A main reason seemed to be that the patient refuses a laxative. Improvement measures should therefore focus on communication between GPs and patients on the relevance of co-using a laxative with opioids. Future studies need to establish the effect of such improvement measures, and determine whether reasons for non-adherence to the guideline changed over time.

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Nursing Support for Constipation in Patients with Cancer: A Scoping Review

Nakano,

Kanno,

Kajiwara

et al. 2024

Journal of Palliative Medicine

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Cancer Constipation: Clinical Summary of the ONS Guidelines™ for Opioid-Induced and Non–Opioid-Related Cancer Constipation

Cited by 4 publications

References 9 publications

A Rapid Review on the Management of Constipation for Hospice and Palliative Care Patients

A Rapid Review on the Management of Constipation for Hospice and Palliative Care Patients

Adherence to coprescribing of laxatives with opioids and associated characteristics in general practices in the Netherlands

Nursing Support for Constipation in Patients with Cancer: A Scoping Review

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