This site is intended for health professionals only

Opioid-induced constipation often undiagnosed

Experts from across Europe are today gathering at a scientific symposium held at the fifth European Association for Palliative Care (EAPC) congress in Trondheim, Norway, to discuss the challenges of managing an overlooked and distressing symptom that affects large numbers of patients receiving opioids as part of palliative care management for advanced illness: opioid-induced constipation (OIC).

It is a condition that is often under-diagnosed in patients in the palliative care setting.

As Europe’s population ages, so the number of patients living with advanced illness is likely to increase. Pain relief is often a key part of palliative care and opioids are routinely used to relieve the pain.

However, the effective pain relief provided by opioids is often accompanied with a less welcome side-effect and OIC is a near universal occurrence in patients receiving opioid analgesics in the palliative care setting.

OIC can be so severe, that it may result in patients choosing to sacrifice their pain medication to mitigate the problem.

“OIC usually goes under-diagnosed”, says Professor Kaasa, St Olave’s University Hospital, Norway. “Clinicians don’t ask about it and patients don’t talk about it, which means it is often poorly managed. The discomfort and distress of OIC can affect the quality of life of patients receiving palliative care for advanced illness.”

“OIC is a significant cause of distress”, concurs Dr Philip Larkin, Senior Lecturer in Nursing, National University of Ireland.

“A recent survey showed that a third of patients in Europe with moderate to severe symptoms receive no treatment. We need to put in place a European-wide consensus on how to diagnose and manage this problem now, as the demand for palliative care is growing and is predicted to continue to grow as the population of Europe ages.”

Each year, more than 1.5 million Americans receive palliative care due to an advanced illness, such as incurable cancer, end-stage heart and lung disease, or AIDS. Similar figures are not available for Europe, which may be considered indicative of the fact that this is an overlooked condition and an area of unmet medical need.

The clinical impact of OIC was discussed at a scientific symposium sponsored by Wyeth Pharmaceuticals.

Be in the know
Subscribe to Hospital Pharmacy Europe newsletter and magazine