2024 Volume 39 Issue 1 Pages 64-75
Opioids are widely used for chronic pain; however, they often cause constipation, affecting the quality of life (QOL) and treatment satisfaction and lead to non–adherence to opioid treatment. We conducted a web–based questionnaire survey amongst Japanese patients (overall patients, n=294) with and without opioid induced constipation (OIC) receiving weak opioids for chronic non–cancer musculoskeletal pain to investigate the effect of OIC on QOL, pain, work productivity, and satisfaction with and adherence to analgesics. We compared the data from age– and sex–matched OIC (n=147) vs non–OIC (n=147) groups. In both groups, 97 (66.0%) patients were male and 143 (97.3%) were aged ≥40 years. Tramadol and acetaminophen combination was prescribed to 70.1% (OIC) vs 80.3% (non–OIC) patients. OIC group showed significantly lower QOL than non–OIC group with lower scores for physical functioning, role physical, bodily pain, general health perception, vitality, social functioning, role emotional and mental health (P<0.001). The pain Numerical Rating Scale score was significantly higher (P=0.001) in OIC vs non–OIC group. The overall work impairment (a component of work productivity–activity impairment) was significantly higher (P=0.032) in OIC group. Significantly high (P<0.001) proportion of patients with OIC (58%) reported difficulty in balancing the treatment effectiveness and side effects in overall patients. The low back pain subgroup had comparable results. Overall, patients with OIC receiving weak opioids for chronic non–cancer musculoskeletal pain including low back pain had significantly lower QOL with pain and activity impairments than those without OIC. Aggressive management of OIC might be useful for improving the QOL and pain.
UMIN registration number: UMIN000050413
