Evidence map›Paper›PMID 32124025›Full record

Observational studySupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2020

Rates of appropriate laxative prophylaxis for opioid-induced constipation in veterans with lung cancer: a retrospective cohort study.

Timothy J Brown, Neil Keshvani, Arjun Gupta, Hui Yang, Deepak Agrawal, Tri C Le, David E Gerber, Carlos A Alvarez

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 21% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Timothy J BrownDepartment of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.ORCID https://orcid.org/0000-0002-4843-4639
Neil KeshvaniDepartment of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Arjun GuptaSidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA.
Hui YangSchool of Pharmacy, Texas Tech University Health Sciences Center, Dallas, TX, USA.
Deepak AgrawalDivision of Gastroenterology, Department of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Tri C LeDepartment of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
David E GerberDepartment of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
Carlos A AlvarezSchool of Pharmacy, Texas Tech University Health Sciences Center, Dallas, TX, USA. Carlos.Alvarez@ttuhsc.edu.
The University of Texas Southwestern Medical Center · USTexas Tech University · USJohns Hopkins University · USThe University of Texas at Austin · US

Funding

UT Southwestern Center for Translational Medicine (UL1/KL2/TL1)UL1TR001105 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2013 to 2017
$24.5M
Safety and Effectiveness of Metformin Therapy in Patients with Type 2 Diabetes anK08DK101602 · NIDDK · TEXAS TECH UNIVERSITY HEALTH SCIS CENTER · PI ALVAREZ, CARLOS A · 2014 to 2017
$536k
NCATS NIH HHS UL1 TR001105NIDDK NIH HHS K08 DK101602NIH HHS K24 CA201543-01
6 · The paper itself

Abstract

purposeOpioid-induced constipation (OIC) is the most common side effect in patient-prescribed opioids for cancer pain treatment. Current guidelines recommend routine prescription of a laxative for preventing OIC in all patients prescribed an opioid unless a contraindication exists. We determined patterns of prescription of laxative agents in patients with lung cancer initiating opioids.

methodsWe performed a retrospective cohort study evaluating the prescription of laxatives for OIC to adult patients with incident lung cancer seen in the Veteran's Affairs (VA) system, between January 1, 2003, and December 31, 2016. Exposure to laxative agents was categorized as follows: none, docusate monotherapy, docusate plus another laxative, and other laxatives only. Prevalence of OIC prophylaxis was analyzed using descriptive statistics. Linear regression was performed to identify time trends in the prescription of OIC prophylaxis.

resultsOverall, 130,990 individuals were included in the analysis. Of these, 87% of patients received inadequate prophylaxis (75% no prophylaxis and 12% docusate alone), while 5% received OIC prophylaxis with the unnecessary addition of docusate to another laxative. Through the study period, laxative prescription significantly decreased, while all other categories of OIC prophylaxis were unchanged. We noted an inverse relationship with OIC prophylaxis and likelihood of a diagnosis of constipation at 3 and 6 months.

conclusionsIn this study of veterans with lung cancer, almost 90% received inadequate or inappropriate OIC prophylaxis. Efforts to educate physicians and patients to promote appropriate OIC prophylaxis in combination with systems-level changes are warranted.

Indexed as

AdultAgedAnalgesics, OpioidCancer PainChemopreventionCohort StudiesCross-Sectional StudiesFemaleHumansLaxativesLung NeoplasmsMaleMiddle AgedOpioid-Induced ConstipationPain ManagementPalliative CareAnalgesics, OpioidLaxativesLung cancerOpioidsPalliative careSupportive care

Identifiers

PMID32124025
OpenAlexW3009269406

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.