The Bowel Function Index for Evaluating Constipation in Pain Patients: Definition of a Reference Range for a Non-Constipated Population of Pain Patients

Ueberall, MA; Müller-Lissner, S; Buschmann-Kramm, C; Bosse, B.

doi:10.1177/147323001103900106

Cited by 94 publications

(101 citation statements)

References 25 publications

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“…A reference range of BFI scores for patients without constipation is from 0 to 28.8. This provides a simple discrimination between patients with and without constipation on opioid therapy [Ueberall et al 2011].…”

Section: Diagnosis Of Oicmentioning

confidence: 99%

Opioid-induced constipation: advances and clinical guidance

Nelson

Camilleri

2016

Therapeutic Advances in Chronic Disease

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Currently opioids are the most frequently used medications for chronic noncancer pain. Opioid-induced constipation is the most common adverse effect associated with prolonged use of opioids, having a major impact on quality of life. There is an increasing need to treat opioid-induced constipation. With the recent approval of medications for the treatment of opioid-induced constipation, there are several therapeutic approaches. This review addresses the clinical presentation and diagnosis of opioid-induced constipation, barriers to its diagnosis, effects of opioids in the gastrointestinal tract, differential tolerance to opiates in different gastrointestinal organs, medications approved and in development for the treatment of opioid-induced constipation, and a proposed clinical management algorithm for treating opioid-induced constipation in patients with noncancer pain.

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Section: Diagnosis Of Oicmentioning

confidence: 99%

Opioid-induced constipation: advances and clinical guidance

Nelson

Camilleri

2016

Therapeutic Advances in Chronic Disease

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“…Within the PP-population the mean improvement at last visit was À29.2 (95% CI: À20.2 to À38.2) points. Although the non-constipated group showed statistically significant worsening in BFI, the BFI at all visits remained well below the threshold value of 28.8 which is validated as nonconstipated (25) (Figure 3A). At the end of the extension phase, the mean AE SD BFI was 4.86 AE 10.67 for the non-constipated patients and 34.2 AE 29.5 for the constipated patients, indicating that the reduction in constipation is sustained over time.…”

Section: Bowel Functionmentioning

confidence: 78%

“…Variables were summarised by constipation based on BFI at visit 1. BFI < 28.8 is defined as non-constipated (25), therefore the non-constipated group includes all patients with a BFI < 28.8 at visit 1 and the constipated group includes all patients with a BFI ≥ 28.8 at visit 1.…”

Section: Discussionmentioning

confidence: 99%

“…37.9% of patients were constipated at start of the study (defined and validated as BFI ≥ 28.8) (24,25). These constipated patients showed a significant and clinically relevant (12 points or more) decrease in BFI over time almost reaching normal values at final visit.…”

Section: Discussionmentioning

confidence: 99%

“…The BFI is the mean value of three single items, which are: ease of defecation during the last 7 days according to patient assessment (0-100; 0 = easy/no difficulty, 100 = severe difficulty); feeling of incomplete bowel evacuation during the last 7 days according to patient assessment (0-100; 0 = not at all, 100 = very strong); personal judgment of patient regarding constipation during the last 7 days (0-100; 0 = not at all, 100 = very strong) (24,25). Next to the BFI also two questions on bowel movements (number of bowel movements in the last 7 days and the number of days with a bowel movement in the last 7 days) were used to assess constipation.…”

Section: Efficacy Outcomes and Assessmentsmentioning

confidence: 99%

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Patient preference with respect to QoL and reduction in opioid‐induced constipation ( OIC ) after treatment with prolonged‐release ( PR ) oxycodone/naloxone compared with previous analgesic therapy [ PREFER study]

Vanelderen

Koopmans-Klein

et al. 2014

Int J Clin Pract

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Objective: The aim of this study was to assess patient preference in terms of quality of life (QoL), analgesia and bowel function for patients with moderate to severe chronic non-malignant pain, when treated with oxycodone PR/naloxone PR compared with the previous WHO-step I and/or WHO-step II analgesic treatment . Study design: This was a 3-week open-label phase 3b study conducted in Belgium and the Netherlands, after 3 weeks patients could enter an extension phase. Patient preference with respect to QoL for oxycodone PR/naloxone PR treatment compared with previous WHO-step I and/or WHO-step II analgesics was assessed. A patient was considered a responder with respect to QoL if this assessment was 'better' or 'much better' compared with previous WHO-step I or II analgesics at any time point. Results: Response rate with respect to QoL was 59.2% (95% CI: 51.7-66.8%) for the Full Analysis (FA)-population, for the Per Protocol-population response rate was 71.7% (95% CI: 63.1-80.3%). Explorative analysis showed that response rate with respect to QoL was highest in constipated patients pretreated with WHO-step II analgesics (73.8%). Mean AE SD pain score in the FA-population at start was 74.7 AE 16.6 decreasing to 53.9 AE 24.3 after a median (range) treatment period of 173.5 (31-771) days. For constipated subjects the significant reduction in constipation [improvement of the Bowel Function Index (BFI)], was À24.8 points (95% CI: À17.1 to À32.5). BFI for non-constipated subjects remained well below 28.8. Adverse events with oxycodone PR/naloxone PR treatment were well-known opioid-related adverse events. Conclusion: This study shows that the studied patients previously treated with WHO-step I and/or WHOstep II analgesics prefer treatment with oxycodone PR/naloxone PR with respect to QoL. Moreover, the study shows that treatment with oxycodone PR/naloxone PR significantly reduces OIC in constipated patients and that non-constipated patients do not develop OIC during treatment with oxycodone PR/naloxone PR. What's knownOxycodone PR/Naloxone PR improves bowel function without affecting analgesia in patients treated with WHO-step III analgesics and symptoms of OIC. What's newPatients previously treated with WHO-step I and/or WHO-step II analgesics prefer treatment with oxycodone PR/naloxone PR with respect to quality of life. Oxycodone PR/Naloxone PR prevents OIC in nonconstipated subjects and improves OIC in constipated subjects even after previous treatment with WHOstep I and/or WHO-step II analgesics.

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Incidence of opioid‐induced constipation in Japanese patients with cancer pain: A prospective observational cohort study

et al. 2019

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This multicenter, prospective, observational cohort study assessed opioid induced constipation (OIC) in Japanese patients with cancer. Eligible patients had stable cancer and an ECOG PS of 0‐2. OIC incidence based on the Rome IV diagnostic criteria was determined by patient diary entries during the first 14 days of opioid therapy. The proportion of patients with OIC was calculated for each 1‐week period and the overall 2‐week study period. Secondary measurements of OIC included the Bowel Function Index (BFI) score (patient assessment administered by physician), spontaneous bowel movements (SBMs) per week (patient assessment), and physician assessments. Medication for constipation was allowed. Two hundred and twenty patients were enrolled. The mean morphine‐equivalent dose was 22 mg/day. By Rome IV criteria, the cumulative incidence of OIC was 56% (95% CI: 49.2%‐62.9%); week 1, 48% (95% CI: 40.8%‐54.6%); week 2, 37% (95% CI: 30.1%‐43.9%). The cumulative incidence of OIC was lower in patients who received prophylactic agents for constipation (48% [95% CI: 38.1%‐57.5%]) than in patients who did not (65% [95% CI: 55.0%‐74.2%]). The cumulative incidences of OIC were 59% (95% CI: 51.9%‐66.0%), 61% (95% CI: 54.3%‐68.1%), and 45% (95% CI: 38.0%‐51.8%) based on BFI scores, physician assessments, and SBM frequency, respectively. Frequency of BMs/week before starting opioids was the most influential factor for the occurrence of OIC. Utilization of prophylactic agents for constipation was associated with a modest effect on reducing the incidence of OIC. The incidences of OIC reported were variable depending on the diagnostic tool involved.

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The Bowel Function Index for Evaluating Constipation in Pain Patients: Definition of a Reference Range for a Non-Constipated Population of Pain Patients

Abstract: Opioid-induced constipation (OIC) is

Cited by 94 publications

References 25 publications

Opioid-induced constipation: advances and clinical guidance

Opioid-induced constipation: advances and clinical guidance

Patient preference with respect to QoL and reduction in opioid‐induced constipation ( OIC ) after treatment with prolonged‐release ( PR ) oxycodone/naloxone compared with previous analgesic therapy [ PREFER study]

Incidence of opioid‐induced constipation in Japanese patients with cancer pain: A prospective observational cohort study

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