Bell Timothy, Annunziata Kathy, Leslie John B
GlaxoSmithKline, Research Triangle Park, NC, USA.
J Opioid Manag. 2009 May-Jun;5(3):137-44. doi: 10.5055/jom.2009.0014.
To characterize the impact of opioid-induced constipation (OIC) on healthcare resource use, work productivity, and health-related quality of life (HRQOL) in patients receiving chronic opioid therapy.
Data were collected via Internet questionnaires during the international National Health and Wellness Survey (NHWS) 2004 from individuals aged > or = 18 years who reported taking opioids for > or = 6 months. Healthcare resource utilization, Work Productivity, and Activity Impairment, and Short-Form 8 (SF-8) questionnaire responses were compared between those who did or did not report OIC.
Data were available from 2,430 individuals receiving opioids, of whom 359 reported OIC. Participants with OIC reported significantly more physician visits (mean difference 3.84 visits; p < 0.05) and alternative care provider visits (mean difference 1.73 visits; p < 0.05) over the previous 6 months than those without OIC; however, no significant differences in emergency room visits or number of days of hospitalization were observed. Respondents with OIC also reported significantly greater time missed from work, impairment while working, overall work impairment, and activity impairment (p < 0.05 for all comparisons). HRQOL scores were significantly lower in the OIC group than those without OIC on both the physical and mental components of the SF-8 questionnaire (p < 0.05 for both comparisons).
The survey results reflect a negative impact of OIC on individuals' HRQOL and on society in terms of healthcare resource use and work productivity beyond that imposed by patients' pain conditions. These findings indicate a need for effective treatment for opioid-induced constipation in patients receiving chronic opioid therapy.
描述阿片类药物引起的便秘(OIC)对接受慢性阿片类药物治疗患者的医疗资源使用、工作效率和健康相关生活质量(HRQOL)的影响。
在2004年国际国民健康与幸福调查(NHWS)期间,通过互联网问卷收集年龄≥18岁且报告服用阿片类药物≥6个月的个体的数据。比较报告或未报告OIC的患者在医疗资源利用、工作效率和活动障碍以及简短健康调查问卷8(SF - 8)的回答情况。
共有2430名接受阿片类药物治疗的个体提供了数据,其中359人报告有OIC。与未患OIC的参与者相比,患OIC的参与者在过去6个月中看医生的次数(平均差异3.84次;p < 0.05)和看替代护理提供者的次数(平均差异1.73次;p < 0.05)显著更多;然而,在急诊室就诊次数或住院天数方面未观察到显著差异。报告有OIC的受访者还报告称,误工时间、工作时的障碍、总体工作障碍和活动障碍显著更多(所有比较p < 0.05)。在SF - 8问卷的身体和精神方面,OIC组的HRQOL得分均显著低于未患OIC的组(两次比较p < 0.05)。
调查结果反映出,OIC对个体的HRQOL以及社会在医疗资源使用和工作效率方面产生了负面影响,超出了患者疼痛状况所带来的影响。这些发现表明,对于接受慢性阿片类药物治疗的患者,需要有效治疗阿片类药物引起的便秘。