Evidence map›Paper›PMID 32940898›Full record

ArticlePain and therapy2020

What to Do and What Not to Do in the Management of Opioid-Induced Constipation: A Choosing Wisely Report.

Domenico Alvaro, Augusto Tommaso Caraceni, Flaminia Coluzzi, Walter Gianni, Fabio Lugoboni, Franco Marinangeli, Giuseppe Massazza, Carmine Pinto, Giustino Varrassi

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain and therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
2.1field-weighted citation impact, top 12% 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

17 citing papers in PubMed, 19 citations in OpenAlex.

  1. Review
  2. PAMORAs in Opioid-Induced Constipation: Are We Following the Guidelines?Clinical and translational gastroenterology · 2025
    Article
  3. Review
  4. Article
  5. Opioid Use and Gut Dysbiosis in Cancer Pain Patients.International journal of molecular sciences · 2024
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 9 institutions in 1 country.

Domenico AlvaroDepartment of Translational and Precision Medicine, Gastroenterology Division, Sapienza University of Rome, Rome, RM, Italy.
Augusto Tommaso CaraceniPalliative Care, Pain Therapy, and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, MI, Italy.
Flaminia ColuzziDepartment of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, LT, Italy. flaminia.coluzzi@uniroma1.it.ORCID http://orcid.org/0000-0001-7184-5519
Walter GianniDepartment of Internal Medicine and Geriatry, University Hospital Policlinico Umberto I, Rome, RM, Italy.
Fabio LugoboniDepartment of Medicine, Addiction Unit, University Hospital of Verona, Verona, VR, Italy.
Franco MarinangeliDepartment of Anesthesiology, Pain Medicine, and Palliative care, University of L'Aquila, L'Aquila, AQ, Italy.
Giuseppe MassazzaDivision of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin and "Città della Salute e della Scienza" University Hospital, Turin, TO, Italy.
Carmine PintoMedical Oncology Unit, Clinical Cancer Center, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy.
Giustino VarrassiPaolo Procacci Foundation, Rome, RM, Italy.
Azienda Sanitaria Unità Locale di Reggio Emilia · ITCTO Andrea Alesini · ITFondazione IRCCS Istituto Nazionale dei Tumori · ITFondazione Roma · ITPoliclinico Umberto I · ITSapienza University of Rome · ITUniversity of L'Aquila · ITUniversity of Turin · ITUniversity of Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite the essential utility of opioids for the clinical management of pain, opioid-induced constipation (OIC) remains an important obstacle in clinical practice. In patients, OIC hinders treatment compliance and has negative effects on quality of life. From a clinician perspective, the diagnosis and management of OIC are hampered by the absence of a clear, universal diagnostic definition across disciplines and a lack of standardization in OIC treatment and assessment.

methodsA multidisciplinary panel of physician experts who treat OIC was assembled to identify a list of ten corrective actions-five "things to do" and five "things not to do"-for the diagnosis and management of OIC, utilizing the Choosing Wisely methodology.

resultsThe final list of corrective actions to improve the diagnosis and clinical management of OIC emphasized a need for: (i) better physician and patient education regarding OIC; (ii) systematic use of diagnostically validated approaches to OIC diagnosis and assessment (i.e., Rome IV criteria and Bristol Stool Scale, respectively) across various medical contexts; and (iii) awareness about appropriate, evidence-based treatments for OIC including available peripheral mu-opioid receptor antagonists (PAMORAs).

conclusionsPhysicians who prescribe long-term opioids should be forthcoming with patients about the possibility of OIC and be adequately versed in the most recent guideline recommendations for its management.

Indexed as

Bristol Stool ScaleChronic constipationOpioid-induced constipationPeripheral mu-opioid receptor antagonistRome IV criteria

Identifiers

PMID32940898
PMCPMC7648765
OpenAlexW3087498836

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.