Lugoboni Fabio, Hall Genevieve, Banerji Vivek
Addiction Unit, Verona University Hospital, Verona, Italy.
Insight Dojo Ltd, London, UK.
Drugs Context. 2021 Oct 22;10. doi: 10.7573/dic.2021-7-2. eCollection 2021.
Although opioid-induced bowel dysfunction is a well-known and frequent adverse event correlated with opioids, it is scarcely investigated in patients on opioid substitution treatment (OST) and no standard of care is currently available for this population. We aimed to explore the opinion of patients on the impact of constipation on the management of OST and quality of life (QoL).
We performed a survey that was directed to opioid-dependent patients treated with OST and followed-up in a Service for Addiction Treatment in Italy. The questionnaire included questions about sociodemographic characteristics, the experience of constipation, general QoL, OST management, interference of opioid-induced constipation (OIC) with opioid management, the experience of OIC treatment in the health system, and risk factors for constipation.
Constipation at the moment of the survey (=105) was reported by 81% of patients and was the most frequent adverse event of OST; 73% of respondents reported at least one severe or very severe symptom of constipation in the last 2 weeks. OIC was reported to hinder adherence to OST by 33% of respondents and 38% of them felt that control of craving had been more difficult since initiation of constipation. Overall, 34% of patients interfered with their OST by changing the schedule on their own in an attempt to improve constipation. Patients were proactive in looking for a solution for constipation but reported poor help from the healthcare system.
Our patient-based survey suggests that careful and efficient management of constipation could increase adherence to OST and improve patient satisfaction and QoL.
尽管阿片类药物引起的肠道功能障碍是一种与阿片类药物相关的广为人知且常见的不良事件，但在接受阿片类药物替代治疗（OST）的患者中对此研究甚少，目前该人群尚无标准的治疗方案。我们旨在探讨患者对便秘对OST管理及生活质量（QoL）影响的看法。
我们对在意大利一家成瘾治疗服务机构接受OST治疗并进行随访的阿片类药物依赖患者进行了一项调查。问卷包括有关社会人口学特征、便秘经历、总体生活质量、OST管理、阿片类药物引起的便秘（OIC）对阿片类药物管理的干扰、在医疗系统中接受OIC治疗的经历以及便秘危险因素等问题。
在调查时（n = 105），81%的患者报告有便秘，这是OST最常见的不良事件；73%的受访者报告在过去2周内至少有一次严重或非常严重的便秘症状。33%的受访者报告OIC阻碍了对OST的依从性，其中38%的人认为自便秘开始以来对渴望的控制变得更加困难。总体而言，34%的患者自行改变用药计划以试图改善便秘，从而干扰了他们的OST。患者积极主动地寻求便秘的解决方案，但报告称医疗系统提供的帮助很少。
我们基于患者的调查表明，对便秘进行仔细有效的管理可以提高对OST的依从性，并改善患者满意度和生活质量。
