PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands.
J Med Econ. 2010 Mar;13(1):129-35. doi: 10.3111/13696990903584436.
Opioid users often experience constipation. In this study the impact of constipation on QoL was assessed in patients using opioids either for non-advanced illness or advanced illness.
Patients using opioids, recruited via public pharmacies, were asked to complete questionnaires on opioid use, constipation and the EuroQol five-dimension questionnaire (EQ-5D). Patients with a severe non-curable disease and relatively short life-expectancy were classified as having an advanced illness; a disabling yet not directly life-threatening condition was defined as non-advanced illness. Constipation was assessed based on questions on opioid side-effects and laxative use. EQ-5D index scores were compared between patients with and without constipation using Wilcoxon two-samples test.
Questionnaires were returned by 588 patients with non-advanced illness, of whom 326 (55%) were classified as having constipation and by 113 patients with advanced illness, of whom 76 (67%) were classified as having constipation. The median EQ-5D index, a weighted health state index score with 1 = full health, was lower in patients with constipation than in patients without constipation (0.31 vs. 0.65, p< 0.01 for non-advanced illness and 0.41 vs. 0.61, p=0.12 for advanced illness).
The results of this study suggest that, in patients using opioids either for non-advanced illness or advanced illness, constipation negatively influences QoL. By separately analysing patients with advanced illness and patients with non-advanced illness, possible selective non-response and confounding was accounted for, but not completely solved.
阿片类药物使用者常出现便秘。本研究评估了非晚期或晚期疾病患者因便秘对生活质量（QoL）的影响。
通过公共药店招募使用阿片类药物的患者，要求其完成阿片类药物使用、便秘和欧洲五维健康量表问卷（EQ-5D）。将患有严重不可治愈疾病和预期寿命相对较短的患者归类为晚期疾病患者；将存在致残但不直接威胁生命的状况定义为非晚期疾病。便秘通过询问阿片类药物副作用和泻药使用情况进行评估。使用 Wilcoxon 两样本检验比较有无便秘患者的 EQ-5D 指数评分。
共回收 588 例非晚期疾病患者的问卷，其中 326 例（55%）被归类为便秘患者，113 例晚期疾病患者中，76 例（67%）被归类为便秘患者。便秘患者的 EQ-5D 指数中位数（加权健康状态指数评分，1 分表示完全健康）低于无便秘患者（非晚期疾病为 0.31 对 0.65，p<0.01；晚期疾病为 0.41 对 0.61，p=0.12）。
本研究结果表明，无论非晚期或晚期疾病，阿片类药物使用者便秘均会对 QoL 产生负面影响。通过分别分析晚期疾病和非晚期疾病患者，虽然考虑到了可能的选择性不回复和混杂因素，但并未完全解决。
