Medication Use Evaluation of Docusate Sodium in Constipation Prophylaxis and Opioid Induced Constipation at the WPB VA HCS Community Living Center.

Autor:	Faulkner W; Departement of Pharmacy Service, VA North Texas Health Care System, Dallas, TX, USA., DiScala S; West Palm Beach VA Health Care Services, West Palm Beach, FL, USA., Vartan C; West Palm Beach VA Health Care Services, West Palm Beach, FL, USA., Dakroub B; West Palm Beach VA Health Care Services, West Palm Beach, FL, USA., Silverman M; West Palm Beach VA Health Care Services, West Palm Beach, FL, USA., Bharadwaj M; West Palm Beach VA Health Care Services, West Palm Beach, FL, USA.
Jazyk:	angličtina
Zdroj:	The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2024 Oct; Vol. 41 (10), pp. 1166-1172. Date of Electronic Publication: 2023 Nov 24.
DOI:	10.1177/10499091231218390
Abstrakt:	Introduction: Docusate sodium's efficacy is widely debated. Several studies on opioid induced constipation (OIC) concluded that docusate sodium vs either placebo or in combination with sennosides provided no benefit. Objective: This medication use evaluation aimed to investigate constipation treatment trends within the West Palm Beach VA Healthcare System Community Living Center, and to assess the therapeutic effectiveness of docusate sodium. Methods: This was a retrospective review of data extracted from April 1, 2022, to September 30, 2022. Patients were included if they had oral orders for docusate sodium, sennosides, lactulose, and/or polyethylene glycol. Patients without active bowel regimen medications were excluded. Requirements for rescue constipation medication was evaluated. Results: A total of 98 patients were reviewed. Docusate sodium was used in 43% (n = 42/98) of patients. Rescue medications were needed in 58% (n = 22/38) of patients receiving oral docusate sodium. 52% (n = 29/56) of patients without docusate sodium required rescue medications. For OIC treatment, when docusate sodium was added to other bowel regimens, 59% (n = 17/29) of patients needed a rescue medication, while 66% (n = 19/29) of patients without docusate sodium required a rescue medication. Patients on morphine were given the greatest quantity of rescue constipation medications (73%, n = 16/22). Conclusion: Oral docusate sodium did not reduce the requirement for rescue constipation medications in the WPB VAHCS CLC population. When evaluating constipation treatment, docusate sodium may supply minimal benefit and could be identified as nonessential for deprescribing efforts. Morphine was the most constipating opioid used in this patient population, requiring more aggressive bowel regimens. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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