Advances in Management of Opioid-Induced Constipation:
Insights for Physical Therapists
Online continuing education, featured on
February 3, 2017
Archived, for viewing purposes only.
The problem of prescription opioid use has grown to epidemic proportions that recent federal guidelines (National Pain Strategy) have been issued focusing on pain management practices and team-based care in which multiple treatment options are offered [NPS 2016]. The CDC also recently released guidelines for prescribing opioids for chronic pain, which clearly states that nonpharmacologic alternatives to prescription opioids, such as physical therapy, are the preferred option for treating chronic pain [Dowell 2016].
Physical therapists are essential resources for patients suffering from OIC. They are integral to the healthcare team and are in a pivotal position to identify signs and symptoms of OIC and recognize when uncontrolled pain may be due to lack of patient compliance. They can make clinical recommendations that can effectively prevent, manage, and treat OIC. As such it is important for PTs to be educated about effective options for OIC in treating the patients they manage, approaching overall treatment plans, and collaborating as part of the interdisciplinary team.
Upon completion of this continuing competence program, the participant will be able to:
- Provide physical therapy and collaborative decision making, as part of a multidisciplinary team, in managing patients with OIC employing a multimodal range of non-pharmacological and pharmacological approaches
- Review the epidemiology, evaluation and clinical impact (disease severity and quality-of-life) of opioid-induced constipation (OIC)
- Identify how opioid analgesia affects the gastrointestinal tract and creates risk for OIC
- Distinguish etiology of OIC from other forms of constipation
- Summarize current guidelines for appropriate opiate use in chronic nonmalignant pain
- Apply pharmacologic and nonpharmacologic strategies to managing OIC
- Describe the clinical efficacy and safety data for PAMORA and the potential impact of these agents on constipation severity, use of healthcare resources, and quality-of-life