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• W4381125412 abstract "<h3>Introduction</h3> Opiate-induced constipation is a common ailment amongst hospital inpatients, particularly in post-operative surgical patients. The response to laxative therapy is wide-ranging, with some patients remaining constipated despite treatment. Naloxegol is a gastrointestinal opiate antagonist that has approval from the National Institute of Clinical Excellence to treat opiate-induced constipation in patients failing laxative therapy. We present a Quality Improvement Project on the management of opiate-induced constipation failing laxative therapy, comparing standard therapy (continuation of laxative therapy) with a proposed alterative (prescription of Naloxegol) on a 30-bed post-operative surgical ward. <h3>Methods</h3> Aim – to reduce opiate-induced constipation in patients failing laxative therapy. Intervention – the prescription of Naloxegol in patients failing laxative therapy (defined as bowels not opening for ≥3 days, despite 4 consecutive days of laxatives). All laxatives were stopped on prescription of Naloxegol, and naloxegol was stopped on cessation of opiates. Baseline data collection – review of inpatients on opiates from the previous two months and identification of those failing laxative therapy. Measuring time taken for bowels to open and average number of bowel motions/week following the failure of laxative therapy. Prospective data collection – Weekly monitoring of bowel motions and rate of failing laxative therapy, measuring time taken for bowels to open and average number of bowel motions/week following the first prescription of Naloxegol, monitoring for adverse effects of Naloxegol (abdominal pain, nausea, headache). <h3>Results</h3> <h3>Baseline data</h3> 110 patients were admitted October to November 2022, with the total of 36 on opiates. 63.9% of patients on opiates (23/36) failed laxative therapy during their admission. Following the failure of laxative therapy, the average time to bowels opening was 4 days and the average number of bowel motions/week was 2.65. <h3>Prospective data</h3> The project ran over 8 weeks from December 2022 to January 2023. A total of 58 patients were prescribed opiates, with 67.2% failing laxative therapy (39/58). A total of 13 patients were prescribed Naloxegol. Average time to bowels opening was 1.5 days (baseline of 4 days), with average number of bowel motions 5.1/week (baseline of 2.65). There were no adverse side effects from Naloxegol use. In addition, patients reported an improved experience using Naloxegol, finding it easier to take with a good laxative effect. <h3>Conclusions</h3> This project demonstrates how Naloxegol is both effective and fast-acting in the management of opiate-induced constipation failing laxative therapy, along with an improved patient experience. Our next steps include a cost analysis of Naloxegol vs. laxatives to assess the feasibility of more widespread inpatient use." @default.
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• W4381125412 date "2023-06-01" @default.
• W4381125412 modified "2023-09-27" @default.
• W4381125412 title "P257 Naloxegol for opiate-induced constipation in inpatients failing laxative therapy" @default.
• W4381125412 doi "https://doi.org/10.1136/gutjnl-2023-bsg.325" @default.
• W4381125412 hasPublicationYear "2023" @default.
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