SynthesisSchmerz (Berlin, Germany)2012
[Is the pharmacological treatment of constipation in palliative care evidence based? : a systematic literature review].
Synthesis in Schmerz (Berlin, Germany), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Mu-opioid antagonists for opioid-induced bowel dysfunction in people with cancer and people receiving palliative care.The Cochrane database of systematic reviews · 2022Pooled it
- [Recommendations of the second update of the LONTS guidelines : Long-term opioid therapy for chronic noncancer pain].Schmerz (Berlin, Germany) · 2020Pooled it
- Mu-opioid antagonists for opioid-induced bowel dysfunction in people with cancer and people receiving palliative care.The Cochrane database of systematic reviews · 2018Pooled it
- Laxatives for the management of constipation in people receiving palliative care.The Cochrane database of systematic reviews · 2015Pooled it
- Trial
- [Interprofessional symptom management at the end of life].Der Urologe. Ausg. A · 2018Article
- [Interprofessional symptom management at the end of life].Der Anaesthesist · 2017Review
- [Care of patients with cancer pain in general practices in Germany].Schmerz (Berlin, Germany) · 2016Article
- [Incidence of constipation in patients with outpatient opioid therapy].Schmerz (Berlin, Germany) · 2016Article
- Palliative Care of Adult Patients With Cancer.Deutsches Arzteblatt international · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
MATERIALS AND
methodsTo evaluate the evidence for clinically established pharmacological therapies for constipation in palliative care, a systematic literature review was performed in different databases (Cochrane Library, Embase, PubMed, Ovid MEDLINE, CINAHL), textbooks, and publications.
resultsWhereas 130 randomized controlled trials were found with patients outside of palliative care settings, only 10 controlled studies with patients in end-of-life situations were identified: three RCTs with methylnaltrexone and one with the combination of oxycodone and naloxone showed the effect and safety of opiate antagonists for patients who are not at risk of gastrointestinal perforation. There have been no studies which test methylnaltrexone against the optimization of therapy with conventional laxatives. Six other controlled studies of limited quality in design and execution and with only few participants tested naloxone, senna, lactulose, Co-danthramer, an Ayurvedic preparation (Misrakasneham), magnesium hydroxide, fluid paraffin, sodium picosulfate and docusate without finding statistically significant differences in efficacy or side effects. Most patients in these studies had cancer. Only case studies with few patients in palliative care were found for meglumine, neostigmine, and other substances mentioned above.
conclusionEvidence on medical treatment of constipation in palliative care is sparse and guidelines have to refer to evidence from outside the palliative care setting and to expert opinions. Results from studies with other patient groups can only be transferred with limitations to very ill patients at the end of life who might have a higher risk for potential side effects such as gastrointestinal perforation in case of abdominal tumor manifestation. Therefore further studies are required to evaluate the medical treatment of multiple reasons for constipation in these patients. These studies should focus on feasibility, clinical relevance and quality of life. The English full text version of this article will be available in SpringerLink as of November 2012 (under "Supplemental").
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.