ONS guidelines™ for opioid-induced and non-opioid-related cancer constipation

Barbara Rogers; Pamela K. Ginex; Allison Anbari; Brian J. Hanson; Kristine B. LeFebvre; Rachael Lopez; Deborah M. Thorpe; Brenda Wolles; Kerri A. Moriarty; Christine Maloney; Mark Vrabel; Rebecca L. Morgan

doi:10.1188/20.ONF.671-691

ONS guidelines™ for opioid-induced and non-opioid-related cancer constipation

Barbara Rogers
, Pamela K. Ginex
, Allison Anbari
, Brian J. Hanson
, Kristine B. LeFebvre
, Rachael Lopez
, Deborah M. Thorpe
, Brenda Wolles
, Kerri A. Moriarty
, Christine Maloney
, Mark Vrabel
, Rebecca L. Morgan

Office of the Dean of Nursing

Fox Chase Cancer Center
University of Missouri
University of Minnesota Twin Cities
Oncology Nursing Society
National Institutes of Health in Bethesda
INN
Sanford Health
McMaster University

Research output: Contribution to journal › Review article › peer-review

20 Scopus citations

Abstract

PURPOSE: This evidence-based guideline intends to support clinicians, patients, and others in decisions regarding the treatment of constipation in patients with cancer. METHODOLOGIC APPROACH: An interprofessional panel of healthcare professionals with patient representation prioritized clinical questions and patient outcomes for the management of cancer-related constipation. Systematic reviews of the literature were conducted. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to assess the evidence and make recommendations. FINDINGS: The panel agreed on 13 recommendations for the management of opioid-induced and non-opioid-related constipation in patients with cancer. IMPLICATIONS FOR NURSING: The panel conditionally recommended a bowel regimen in addition to lifestyle education as first-line treatment for constipation. For patients starting opioids, the panel suggests a bowel regimen as prophylaxis. Pharmaceutical interventions are available and recommended if a bowel regimen has failed. Acupuncture and electroacupuncture for non-opioid-related constipation are recommended in the context of a clinical trial.

Original language	English
Pages (from-to)	371-391
Number of pages	21
Journal	Oncology nursing forum
Volume	47
Issue number	6
DOIs	https://doi.org/10.1188/20.ONF.671-691
State	Published - Nov 2020

Keywords

Acupuncture
Cancer
Constipation
GRADE
Guideline
Opioid-induced constipation

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10.1188/20.ONF.671-691

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@article{209ec89f57e74c17bb860ec2d94f8845,

title = "ONS guidelines{\texttrademark} for opioid-induced and non-opioid-related cancer constipation",

abstract = "PURPOSE: This evidence-based guideline intends to support clinicians, patients, and others in decisions regarding the treatment of constipation in patients with cancer. METHODOLOGIC APPROACH: An interprofessional panel of healthcare professionals with patient representation prioritized clinical questions and patient outcomes for the management of cancer-related constipation. Systematic reviews of the literature were conducted. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to assess the evidence and make recommendations. FINDINGS: The panel agreed on 13 recommendations for the management of opioid-induced and non-opioid-related constipation in patients with cancer. IMPLICATIONS FOR NURSING: The panel conditionally recommended a bowel regimen in addition to lifestyle education as first-line treatment for constipation. For patients starting opioids, the panel suggests a bowel regimen as prophylaxis. Pharmaceutical interventions are available and recommended if a bowel regimen has failed. Acupuncture and electroacupuncture for non-opioid-related constipation are recommended in the context of a clinical trial.",

keywords = "Acupuncture, Cancer, Constipation, GRADE, Guideline, Opioid-induced constipation",

author = "Barbara Rogers and Ginex, \{Pamela K.\} and Allison Anbari and Hanson, \{Brian J.\} and LeFebvre, \{Kristine B.\} and Rachael Lopez and Thorpe, \{Deborah M.\} and Brenda Wolles and Moriarty, \{Kerri A.\} and Christine Maloney and Mark Vrabel and Morgan, \{Rebecca L.\}",

year = "2020",

month = nov,

doi = "10.1188/20.ONF.671-691",

language = "English",

volume = "47",

pages = "371--391",

journal = "Oncology nursing forum",

issn = "0190-535X",

number = "6",

}

TY - JOUR

T1 - ONS guidelines™ for opioid-induced and non-opioid-related cancer constipation

AU - Rogers, Barbara

AU - Ginex, Pamela K.

AU - Anbari, Allison

AU - Hanson, Brian J.

AU - LeFebvre, Kristine B.

AU - Lopez, Rachael

AU - Thorpe, Deborah M.

AU - Wolles, Brenda

AU - Moriarty, Kerri A.

AU - Maloney, Christine

AU - Vrabel, Mark

AU - Morgan, Rebecca L.

PY - 2020/11

Y1 - 2020/11

N2 - PURPOSE: This evidence-based guideline intends to support clinicians, patients, and others in decisions regarding the treatment of constipation in patients with cancer. METHODOLOGIC APPROACH: An interprofessional panel of healthcare professionals with patient representation prioritized clinical questions and patient outcomes for the management of cancer-related constipation. Systematic reviews of the literature were conducted. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to assess the evidence and make recommendations. FINDINGS: The panel agreed on 13 recommendations for the management of opioid-induced and non-opioid-related constipation in patients with cancer. IMPLICATIONS FOR NURSING: The panel conditionally recommended a bowel regimen in addition to lifestyle education as first-line treatment for constipation. For patients starting opioids, the panel suggests a bowel regimen as prophylaxis. Pharmaceutical interventions are available and recommended if a bowel regimen has failed. Acupuncture and electroacupuncture for non-opioid-related constipation are recommended in the context of a clinical trial.

AB - PURPOSE: This evidence-based guideline intends to support clinicians, patients, and others in decisions regarding the treatment of constipation in patients with cancer. METHODOLOGIC APPROACH: An interprofessional panel of healthcare professionals with patient representation prioritized clinical questions and patient outcomes for the management of cancer-related constipation. Systematic reviews of the literature were conducted. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to assess the evidence and make recommendations. FINDINGS: The panel agreed on 13 recommendations for the management of opioid-induced and non-opioid-related constipation in patients with cancer. IMPLICATIONS FOR NURSING: The panel conditionally recommended a bowel regimen in addition to lifestyle education as first-line treatment for constipation. For patients starting opioids, the panel suggests a bowel regimen as prophylaxis. Pharmaceutical interventions are available and recommended if a bowel regimen has failed. Acupuncture and electroacupuncture for non-opioid-related constipation are recommended in the context of a clinical trial.

KW - Acupuncture

KW - Cancer

KW - Constipation

KW - GRADE

KW - Guideline

KW - Opioid-induced constipation

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U2 - 10.1188/20.ONF.671-691

DO - 10.1188/20.ONF.671-691

M3 - Review article

C2 - 33063786

AN - SCOPUS:85093492173

SN - 0190-535X

VL - 47

SP - 371

EP - 391

JO - Oncology nursing forum

JF - Oncology nursing forum

IS - 6

ER -

ONS guidelines™ for opioid-induced and non-opioid-related cancer constipation

Abstract

Keywords

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