Advances in the Management of Opioid-Induced Constipation in Cancer-Related Pain
Medscape Posting of the CME/CNE Symposium Presented at the
4^th Annual Cancer Research Pain Consortium Conference
April 14, 2018
New Orleans, LA
Archived, for viewing purposes only.

Purpose

Cancer-related pain (CRP) is a burdensome symptom with the potential to negatively impact quality-of-life (QoL) for patients and their families. A recent meta-analysis reported pooled prevalence rates of 55% for CRP in patients who were receiving disease modifying treatment and 64% in those with advanced metastatic or terminal disease. However, CRP may be controlled in up to 90% cases with appropriate analgesic therapies. When the etiology of pain is related to active cancer of any type, and its intensity is moderate or severe, there is consensus that opioid therapy is first-line therapy.

While effective, opioids are commonly associated with opioid-induced constipation (OIC), an adverse event that is well-known to physicians and especially, to oncology advanced practitioners. OIC is often unrecognized, under assessed, and ineffectively managed, and may compromise the effectiveness of the patient’s comprehensive treatment plan, and has been reported to interfere with pain management, increase healthcare costs, decrease work productivity and daily activities, and significantly affect QoL. The National Comprehensive Cancer Network (NCCN) recognizes the burden of OIC to the patient and advises in their Adult Cancer Pain guidelines that “patients taking daily opioids almost always require agents for the management of constipation” and that “prevention of expected analgesic effects, especially constipation in the setting of opioid use, is key for effective pain management”.

Thus, clinicians, physicians and oncology advanced practitioners, need to be aware that the appropriate use of opioids, as well as assessment and management of OIC, are important strategies for pain management and establishing maximum function for cancer patients. This CME/CNE symposium features a multi-disciplinary faculty presenting insights and experience to guide clinicians collaboratively through the challenges and opportunities of managing OIC in cancer patients.

Learning Objectives

After attending this educational activity, participants should be able to:

• Provide care and collaborative decision making, as part of a multi-disciplinary team, including oncology advanced practitioners and clinical nurse specialists, in managing patients with OIC employing a multimodal range of non-pharmacological and pharmacological approaches
• Summarize current NCCN guidelines for opiate use in chronic malignant pain
• Identify how opioid analgesia affects the GI tract and creates risk for OIC
• Review the epidemiology, evaluation & clinical impact of OIC
• Make recommendations for pharmacologic and nonpharmacologic strategies
  to managing OIC
• Assess current pharmacologic treatment in managing OIC

Agenda Faculty

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