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Assessment of a Stool Symptom Screener and Understanding the Opioid-Induced Constipation Symptom Experience

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Abstract

Background

Many patients with chronic opioid-induced constipation (OIC) seek treatment to relieve their symptoms. A symptom screener may be useful in identifying symptomatic OIC patients.

Aim

The aims of this study were to assess patient understanding of Stool Symptom Screener content and to evaluate how patients described their constipation experience, to better understand the relationship between constipation symptoms and patterns of laxative use.

Methods

Adult OIC patients were recruited through five clinical sites across the USA. Patients were classified as either frequent or non-frequent laxative users. Patients participated in a semi-structured interview to assess their understanding of a Stool Symptom Screener and to discuss their constipation symptoms and laxative use experience. Interview transcripts were reviewed using content analysis. Descriptive statistics were used to characterize the sample.

Results

Sixty-six OIC patients participated: 39 frequent laxative users (mean age 53.3 years) and 27 non-frequent laxative users (mean age 55.5 years). Both patient groups described high levels of symptom burden on the Stool Symptom Screener as well as anecdotally. Both patient groups generally understood the Stool Symptom Screener items and felt the questions were relevant to their symptom experience. Most (95.5 %) reported that they could remember their constipation symptoms “easily” over the previous 2 weeks. No qualitative differences were found between frequent and non-frequent laxative users in how they described their OIC symptom experience.

Conclusion

OIC patients understood this Stool Symptom Screener, and its content was relevant to this highly symptomatic patient sample. Pain and bloating may be considered as additional symptoms for future versions of the screener. An emerging conceptual model of the OIC experience, laxative use, and symptoms is presented.

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Acknowledgments/Statement Of Interests

Authors’ Contributions and Declaration of Personal Interests

(i) Karin Coyne, PhD, and Brooke Currie, MPH, oversaw the research study that informed the content of this paper, and they drafted the manuscript on the basis of input from co-authors. Karin Coyne and Brooke Currie are employees of Evidera, a health outcomes research organization, and provide scientific consultation to research projects. William Holmes, MD, MSCE, is an employee of AstraZeneca. Joseph Crawley, MS, is a former employee of AstraZeneca. William Holmes and Joseph Crawley provided scientific input throughout the research study and reviewed and provided comments on the manuscript prior to and after its submission.

Declaration of Funding Interests

This study and the writing of this paper were funded in full by AstraZeneca.

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Authors and Affiliations

  1. Evidera, Outcomes Research, 7101 Wisconsin Avenue, Suite 600 Bethesda, MD, 20814, USA

    Karin S. Coyne & Brooke M. Currie

  2. AstraZeneca, 1800 Concord Pike, Wilmington, DE, 19803, USA

    William C. Holmes & Joseph A. Crawley

Authors
  1. Karin S. Coyne
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  2. Brooke M. Currie
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  3. William C. Holmes
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  4. Joseph A. Crawley
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Correspondence to Karin S. Coyne.

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Coyne, K.S., Currie, B.M., Holmes, W.C. et al. Assessment of a Stool Symptom Screener and Understanding the Opioid-Induced Constipation Symptom Experience. Patient 8, 317–327 (2015). https://doi.org/10.1007/s40271-014-0087-7

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  • DOI: https://doi.org/10.1007/s40271-014-0087-7

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