Table 1.
Constipation in people prescribed opioids
| Important outcomes | Bowel movement frequency, stool consistency, abdominal pain, adverse effects | ||||||||
| Number of studies (participants) | Outcome | Comparison | Type of evidence | Quality | Consistency | Directness | Effect size | GRADE | Comment |
| What are the effects of oral laxatives for constipation in people prescribed opioids? | |||||||||
| 1 (57) | Stool consistency | Lactulose v placebo | 4 | –2 | 0 | 0 | 0 | Low | Quality points deducted for sparse data and incomplete reporting of results |
| 1 (57) | Stool consistency | Macrogol/electrolyte solution v placebo | 4 | –2 | 0 | 0 | 0 | Low | Quality points deducted for sparse data and incomplete reporting of results |
| 1 (57 | Stool consistency | Lactulose v polyethylene glycol 3350/electrolyte solution | 4 | –2 | 0 | 0 | 0 | Low | Quality points deducted for sparse data and incomplete reporting of results |
| 1 (91) | Frequency of bowel movements | Lactulose v senna | 4 | –1 | 0 | 0 | 0 | Moderate | Quality point deducted for sparse data |
| 1 (22) | Frequency of bowel movements | Docusate sodium v placebo | 4 | –2 | 0 | –1 | 0 | Very low | Quality points deducted for sparse data and incomplete reporting of results. Directness point deducted for uncertainty about population group |
| What are the effects of rectally applied medications in people for constipation in people prescribed opioids? | |||||||||
| No clinically important studies found | |||||||||
| What are the effects of opioid antagonists for constipation in people prescribed opioids? | |||||||||
| 2 (690) | Frequency of bowel movements | Alvimopan v placebo/no treatment | 4 | –1 | 0 | 0 | 0 | Moderate | Quality point deducted for incomplete reporting of results |
| 2 (287) | Frequency of bowel movements | Methylnaltrexone v placebo/no treatment | 4 | –1 | 0 | 0 | 0 | Moderate | Quality point deducted for incomplete reporting of results |
| 2 (732) | Frequency of bowel movements | Naloxone v placebo/no treatment | 4 | –1 | 0 | 0 | 0 | Moderate | Quality point deducted for incomplete reporting of results |
Type of evidence: 4 = RCT; 2 = Observational; 1 = Non-analytical/expert opinion. Consistency: similarity of results across studies. Directness: generalisability of population or outcomes.