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Risk factors for opioid-induced constipation in cancer patients: a single-institution, retrospective analysis

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Abstract

Purpose

To identify risk factors for opioid-induced constipation (OIC).

Methods

This study retrospectively analyzed 175 advanced cancer patients who were receiving pain treatment with opioids and were newly prescribed laxatives for OIC at Seirei Hamamatsu General Hospital between November 2016 and June 2021. For the regression analysis of factors associated with OIC, variables were extracted manually from clinical records. The effect of newly prescribed laxatives for OIC was evaluated as “effective” in cases where the number of spontaneous bowel movements increased at least once in the first 3 days. The OIC was defined based on Rome IV diagnostic criteria. Multivariate logistic regression analysis was performed to identify risk factors for OIC. Optimal cutoff thresholds were determined using receiver operating characteristic analysis. Values of P < 0.05 (two-tailed) were considered significant.

Results

Significant factors identified included body mass index (BMI) (odds ratio [OR] = 0.141, 95% confidence interval [CI] = 0.027–0.733; P = 0.020), chemotherapy with taxane within 1 month of evaluation of laxative effect (OR = 0.255, 95% CI = 0.068–0.958; P = 0.043), use of naldemedine (OR = 2.791, 95% CI = 1.220–6.385; P = 0.015), and addition or switching due to insufficient prior laxatives (OR = 0.339, 95% CI = 0.143–0.800; P = 0.014).

Conclusion

High BMI, chemotherapy including a taxane within 1 month of evaluation of laxative effect, no use of naldemedine, and addition or switching due to insufficient prior laxatives were identified as risk factors for OIC in advanced cancer patients with cancer pain.

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Data availability

Data are not available due to ethical restrictions.

Code availability

Not applicable.

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Acknowledgements

We wish to thank all the patients and medical staff at Seirei Hamamatsu General Hospital who were involved in this study.

Author information

Authors and Affiliations

  1. Department of Education and Research Center for Clinical Pharmacy, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, 4-20-1 Nasahara, Takatsuki, Osaka, 569-1094, Japan

    Yuko Kanbayashi

  2. Department of Pharmacy, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

    Yuichi Ishizuka, Mayumi Shimizu, Shohei Sawa & Katsushige Yabe

  3. Department of Education and Research Center for Pharmacy Practice, Doshisha Women’s College of Liberal Arts, Kyotanabe, Japan

    Mayako Uchida

Authors
  1. Yuko Kanbayashi
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  2. Yuichi Ishizuka
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  3. Mayumi Shimizu
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  4. Shohei Sawa
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  5. Katsushige Yabe
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  6. Mayako Uchida
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Contributions

YK: concept and design, data analysis, data interpretation, manuscript writing; YI, MS, SS, and KY: concept and design, data acquisition, data interpretation; MU: concept and design, data interpretation, supervision of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yuko Kanbayashi.

Ethics declarations

Ethics approval

The Medical Ethics Review Committee of Seirei Hamamatsu General Hospital approval no. 3310 and the Faculty of Pharmacy, Osaka Medical Pharmaceutical University, approved this study, approval no. 0088. All procedures were performed in accordance with the ethical standards of the Seirei Hamamatsu General Hospital and Osaka Medical Pharmaceutical University of Medicine Institutional Medical Ethics Review Committee and the 1964 Declaration of Helsinki and its later amendments. No prospective studies with human participants or animals were performed by any of the authors for this article.

This study retrospectively analyzed 208 cancer patients newly prescribed laxatives for OIC or OIC prevention at Seirei Hamamatsu General Hospital between November 2016 and June 2021. All study protocols were approved by the Medical Ethics Review Committee at Seirei Hamamatsu General Hospital (approval no. 3310) and the Faculty of Pharmacy at Osaka Medical Pharmaceutical University (approval no. 0088).

Consent to participate

Given the retrospective nature of this work, the need to obtain informed consent was waived for the individual participants included in the study, in accordance with the standards of the Seirei Hamamatsu General Hospital and Osaka Medical Pharmaceutical University of Medicine Institutional Medical Ethics Review Committee.

Consent for publication

All authors give their consent for this manuscript to be published in Supportive Care in Cancer.

Conflict of interest

The authors declare no competing interests.

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Kanbayashi, Y., Ishizuka, Y., Shimizu, M. et al. Risk factors for opioid-induced constipation in cancer patients: a single-institution, retrospective analysis. Support Care Cancer 30, 5831–5836 (2022). https://doi.org/10.1007/s00520-022-07002-9

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  • DOI: https://doi.org/10.1007/s00520-022-07002-9

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