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Akhgarandouz S, Moshiri M, Etemad L, Dadpour B, Khadem-Rezaiyan M, Vahdati-Mashhadian N. Effect of oral naloxone on opioid-induced constipation in methadone maintenance treatment patients, a double-blind, placebo-control, clinical trial. Ir J Med Sci 2024:10.1007/s11845-024-03652-2. [PMID: 38502432 DOI: 10.1007/s11845-024-03652-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/26/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Opioid-induced constipation (OIC) is the most prevalent side effect of methadone maintenance therapy (MMT). Naloxone could reduce the OIC. METHOD Fifty-six MMT cases (< 75 mg/day methadone, > 3 months) were entered randomly into four groups of a trial. They received placebo or naloxone tablets (0.5, 2, or 4 mg/day) once a day for 2 weeks. They continued their conventional laxative. Their constipation and opiate withdrawal (OWS) were evaluated by the Bristol Stool Form Scale (stool consistency and frequency), Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire, Constipation Scoring System (CSS), and the Subjective Opiate Withdrawal Scale (SOWS) before starting treatment and at the end of the first and second weeks. RESULTS The dose of 4 mg/day naloxone was excluded from the study due to severe OWS. The precipitants of groups had similar ages, methadone dose and duration, laxative use, and constipation scores at the start of the trial. However, 2 mg of naloxone could change the stool consistency (PV = 0.0052) and frequency (P = 0.0133), 0.5 mg/day dose only improved the stool consistency (P = 0.0016). The patients' CSS and PAC-SYM scores were reduced by naloxone after the 1st week of treatment. However, there was no significant difference in the mean score of SOWS at different assessment times and groups. Also, 3 and 4 cases of 0.5 and 2 mg/day groups, respectively, withdrew from the study due to OWS. CONCLUSION Oral naloxone at doses of 0.5 and 2 mg/day was significantly more effective than placebo on OIC in MMT. However, the dose of 4 mg induced intolerable OWS.
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Affiliation(s)
| | - Mohammad Moshiri
- Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Etemad
- Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bita Dadpour
- Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khadem-Rezaiyan
- Community medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasser Vahdati-Mashhadian
- Department of Pharmacodynamics and Toxicology, Mashhad University of Medical Sciences, Mashhad, Iran.
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Current Status of Research on the Mapping Function of Health Utility Values in the Asia Pacific Region: A Systematic Review. Value Health Reg Issues 2021; 24:224-239. [PMID: 33894684 DOI: 10.1016/j.vhri.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/11/2020] [Accepted: 12/06/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This systematic review aimed to analyze the published studies on the use of the mapping method between generic scales and disease-specific scales as well as between 2 universal scales. METHODS A systematic literature search was conducted using PubMed, ScienceDirect, Web of Science, CNKI, Weipa Database, Wanfang Database, and HERC Database to collect articles about the application of the mapping method to the measurement of health utility value from January 2000 to December 2019. RESULTS Overall, 59 articles met the inclusion requirements, and most of them were a mapping study between a disease-specific scale and a generic scale. Then all these articles were classified by the following study types: a clear functional relationship; unclear functional relationship; disease-specific scale and universality; mapping between generic scales and disease-specific scales, and mapping between universal scales. Most studies derived the best mapping model from the ordinary least squares regression, and fewer studies chose to use new regression methods. Sample sizes in the retrieved studies generally affected the reliability of the study results. CONCLUSIONS In recent years, as more attention has been paid to the research of the mapping method, a large number of problems have followed, such as the selection of scale types, the coverage of the study sample, and the selection of evaluation index of model performance and sample size. It is hoped that these problems can be properly solved in the future research.
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Dong FF, Ying J. Clinical observation on heat-sensitive moxibustion plus lactulose for postoperative constipation of mixed hemorrhoid due to spleen deficiency. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2020. [DOI: 10.1007/s11726-020-1181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Fumita S, Imai H, Harada T, Noriyuki T, Gamoh M, Akashi Y, Sato H, Kizawa Y, Tokoro A. Patients' Self-Assessment of the Symptoms and Impact of Opioid-Induced Constipation: Results From a Prospective Observational Cohort Study of Japanese Patients With Cancer. J Pain Symptom Manage 2020; 59:1043-1051.e2. [PMID: 31805362 DOI: 10.1016/j.jpainsymman.2019.11.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 12/27/2022]
Abstract
CONTEXT Many patients who have cancer consider opioid-induced constipation (OIC) to be a burdensome side effect of opioid treatment. OBJECTIVES To evaluate patient-reported outcomes in Japanese patients with cancer pain and OIC. METHODS This prospective observational study evaluated OIC incidence for two weeks in patients with cancer after they initiated strong opioid therapy. Rome IV diagnostic criteria, a physician's diagnosis, spontaneous bowel movements, Bowel Function Index score, and patients' daily self-assessments were used. Changes from baseline in Patient Assessment of Constipation Symptoms and Patient Assessment of Constipation Quality of Life (PAC-QOL) scores were compared between patients with and without OIC. Patients and health care providers (HCPs) completed study-specific questionnaires regarding OIC burden, treatment satisfaction, and patient-provider communications. RESULTS Among 212 enrolled patients, the incidence of OIC was 47.6% by patients' self-assessments, with a cumulative incidence of 30.2% by Day 3 and 43.5% by Day 7. Patient Assessment of Constipation Symptoms and PAC-QOL overall scores from patients with OIC worsened significantly from baseline compared with patients without OIC by all diagnostic criteria, except for spontaneous bowel movement frequency for PAC-QOL. Patients and HCPs were generally satisfied with OIC treatment; however, 53.5% of patients and approximately 40.0% of HCPs reported that OIC affected pain management. Most patients and HCPs reported that OIC conditions were sufficiently or essentially communicated. CONCLUSION After starting opioid therapy, patients recognized OIC onset and its impact on cancer pain management, highlighting the need for effective patient-provider communications, diagnosis, and treatment of OIC to improve QOL for patients with cancer receiving opioid analgesics.
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Affiliation(s)
- Soichi Fumita
- Department of Medical Oncology, Kindai University Nara Hospital, Ikoma, Japan
| | - Hisao Imai
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ohta, Japan
| | - Toshiyuki Harada
- Center for Respiratory Diseases, JCHO Hokkaido Hospital, Sapporo, Japan
| | | | - Makio Gamoh
- Department of Medical Oncology, Osaki Citizen Hospital, Osaki, Japan
| | - Yusaku Akashi
- Department of Medical Oncology, Kindai University Nara Hospital, Ikoma, Japan
| | - Hiroki Sato
- Medical Affairs, Shionogi & Co., Ltd., Osaka, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihiro Tokoro
- Department of Psychosomatic Internal Medicine and Supportive and Palliative Care Team, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan.
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Gregory J, Dyer M, Hoyle C, Mann H, Hatswell AJ. The validation of published utility mapping algorithms: an example of EORTC QLQ-C30 and EQ-5D in non-small cell lung cancer. HEALTH ECONOMICS REVIEW 2020; 10:10. [PMID: 32319016 PMCID: PMC7175479 DOI: 10.1186/s13561-020-00269-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Mapping algorithms can be used to generate health state utilities when a preference-based instrument is not included in a clinical study. Our aim was to investigate the external validity of published mapping algorithms in non-small cell lung cancer (NSCLC) between the EORTC QLQ-C30 and EQ-5D instruments and to propose methodology for validating any mapping algorithms. METHODS We conducted a targeted literature review to identify published mappings, then applied these to data from the osimertinib clinical trial programme. Performance of the algorithms was evaluated using the mean absolute error, root mean squared error, and graphical techniques for the observed versus predicted EQ-5D utilities. These statistics were also calculated across the range of utility values (as well as ordinary least squares and quantile regression), to investigate how the mappings fitted across all values, not simply around the mean utility. RESULTS Three algorithms developed in NSCLC were identified. The algorithm based on response mapping (Young et al., 2015) fitted the validation dataset across the range of observed values with similar fit statistics to the original publication (overall MAE of 0.087 vs 0.134). The two algorithms based on beta-binomial models presented a poor fit to both the mean and distribution of utility values (MAE 0.176, 0.178). CONCLUSIONS The validation of mapping algorithms is key to demonstrating their generalisability beyond the original dataset, particularly across the range of plausible utility values (not just the mean) - perceived patient similarity being insufficient. The identified algorithm from Young et al. performed well across the range of EORTC scores observed, and thus appears most suitable for use in other studies of NSCLC patients.
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Affiliation(s)
- Joanne Gregory
- BresMed Health Solutions, Steel City House, West Street, Sheffield, S1 2GQ UK
| | - Matthew Dyer
- AstraZeneca, 126-130 Hills Road, Cambridge, CB2 1RY UK
| | | | - Helen Mann
- AstraZeneca, 126-130 Hills Road, Cambridge, CB2 1RY UK
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More opioids, more constipation? Evaluation of longitudinal total oral opioid consumption and self-reported constipation in patients with cancer. Support Care Cancer 2019; 28:1793-1797. [PMID: 31332514 DOI: 10.1007/s00520-019-04996-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 07/16/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Opioid-induced constipation (OIC) is a distressing physical symptom for patients with cancer taking opioids. Total opioid consumption may contribute to developing worsening OIC-related symptoms. We completed a retrospective analysis examining the association of total daily opioid consumption on self-reported constipation in patients with cancer. METHODS In over 5 clinic visits, we collected self-reported constipation scores and 24-h oral morphine equivalents (OME). We examined the association between OME and the presence of constipation (i.e., score > 3) and the relationship of OME between patients with or without constipation. RESULTS Of 297 patients with cancer, we observed 57.8% with constipation and 42.4% without constipation at the first clinic visit. Age was similar in both groups (54.2 ± 14.5 vs. 56.4 ± 14.8 years [mean ± SD]) and the majority of patients were women (63.7% vs. 61.1%). The most common cancer type in patients with constipation was non-colorectal gastrointestinal (n = 25, 14.6%), while in patients without constipation was colorectal gastrointestinal (n = 25; 19.8%). Across visits, we observed weak or no association between OME and self-reported constipation (r = 0.01-0.27). At the first visit, higher mean OME was seen in patients who self-reported constipation (133.4 vs 76; p < 0.05). Age, sex, metastatic disease, and stimulant laxative use were not associated with constipation. CONCLUSIONS We observed weak to no association between OME and constipation in patients with cancer. These results suggest a lack of a clear association between total opioid consumption and self-reported constipation.
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Mukuria C, Rowen D, Harnan S, Rawdin A, Wong R, Ara R, Brazier J. An Updated Systematic Review of Studies Mapping (or Cross-Walking) Measures of Health-Related Quality of Life to Generic Preference-Based Measures to Generate Utility Values. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2019; 17:295-313. [PMID: 30945127 DOI: 10.1007/s40258-019-00467-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Mapping is an increasingly common method used to predict instrument-specific preference-based health-state utility values (HSUVs) from data obtained from another health-related quality of life (HRQoL) measure. There have been several methodological developments in this area since a previous review up to 2007. OBJECTIVE To provide an updated review of all mapping studies that map from HRQoL measures to target generic preference-based measures (EQ-5D measures, SF-6D, HUI measures, QWB, AQoL measures, 15D/16D/17D, CHU-9D) published from January 2007 to October 2018. DATA SOURCES A systematic review of English language articles using a variety of approaches: searching electronic and utilities databases, citation searching, targeted journal and website searches. STUDY SELECTION Full papers of studies that mapped from one health measure to a target preference-based measure using formal statistical regression techniques. DATA EXTRACTION Undertaken by four authors using predefined data fields including measures, data used, econometric models and assessment of predictive ability. RESULTS There were 180 papers with 233 mapping functions in total. Mapping functions were generated to obtain EQ-5D-3L/EQ-5D-5L-EQ-5D-Y (n = 147), SF-6D (n = 45), AQoL-4D/AQoL-8D (n = 12), HUI2/HUI3 (n = 13), 15D (n = 8) CHU-9D (n = 4) and QWB-SA (n = 4) HSUVs. A large number of different regression methods were used with ordinary least squares (OLS) still being the most common approach (used ≥ 75% times within each preference-based measure). The majority of studies assessed the predictive ability of the mapping functions using mean absolute or root mean squared errors (n = 192, 82%), but this was lower when considering errors across different categories of severity (n = 92, 39%) and plots of predictions (n = 120, 52%). CONCLUSIONS The last 10 years has seen a substantial increase in the number of mapping studies and some evidence of advancement in methods with consideration of models beyond OLS and greater reporting of predictive ability of mapping functions.
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Affiliation(s)
- Clara Mukuria
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Donna Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Sue Harnan
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Andrew Rawdin
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Ruth Wong
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Roberta Ara
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - John Brazier
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
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Katakami N, Harada T, Murata T, Shinozaki K, Tsutsumi M, Yokota T, Arai M, Tada Y, Narabayashi M, Boku N. Randomized phase III and extension studies: efficacy and impacts on quality of life of naldemedine in subjects with opioid-induced constipation and cancer. Ann Oncol 2018; 29:1461-1467. [PMID: 32151367 PMCID: PMC6005145 DOI: 10.1093/annonc/mdy118] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The efficacy and safety of naldemedine (a peripherally acting µ-opioid receptor antagonist) for opioid-induced constipation (OIC) in subjects with cancer was demonstrated in the primary report of a phase III, double-blind study (COMPOSE-4) and its open-label extension (COMPOSE-5). The primary end point, the proportion of spontaneous bowel movement (SBM) responders, was met. Here, we report results from secondary end points, including quality of life (QOL) assessments from these studies. PATIENTS AND METHODS In COMPOSE-4, eligible adults with OIC and cancer were randomly assigned 1:1 to receive once-daily oral naldemedine 0.2 mg (n = 97) or placebo (n = 96) for 2 weeks, and those who continued on to COMPOSE-5 received naldemedine for 12 weeks (n = 131). Secondary assessments in COMPOSE-4 included the proportion of complete SBM (CSBM) responders, SBM or CSBM responders by week, and subjects with ≥1 SBM or CSBM within 24 h postinitial dose. Changes from baseline in the frequency of SBMs or CSBMs per week were assessed at weeks 1 and 2. Time to the first SBM or CSBM postinitial dose was also evaluated. In both studies, QOL impact was evaluated by Patient Assessment of Constipation-Symptoms (PAC-SYM) and PAC-QOL questionnaires. RESULTS Naldemedine improved bowel function for all secondary efficacy assessments versus placebo (all P ≤ 0.0002). The timely onset of naldemedine activity versus placebo was evidenced by median time to the first SBM (4.7 h versus 26.6 h) and CSBM (24.0 h versus 218.5 h) postinitial dose (all P < 0.0001). In COMPOSE-4, significant differences between groups were observed with the PAC-SYM stool domain (P = 0.045) and PAC-QOL dissatisfaction domain (P = 0.015). In COMPOSE-5, significant improvements from baseline were observed for overall and individual domain scores of PAC-SYM and PAC-QOL. CONCLUSIONS Naldemedine provided effective and timely symptomatic relief from OIC and improved the QOL of subjects with OIC and cancer. TRIAL REGISTRATION ID: www.ClinicalTrials.jp: JAPIC-CTI-132340 (COMPOSE-4) and JAPIC-CTI-132342 (COMPOSE-5).
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Affiliation(s)
- N Katakami
- Kobe City Medical Center General Hospital, Kobe, Japan.
| | - T Harada
- Center for Respiratory Diseases, JCHO Hokkaido Hospital, Sapporo, Japan
| | - T Murata
- Department of Breast Oncology, Aichi Cancer Center Aichi Hospital, Okazaki, Japan
| | - K Shinozaki
- Department of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - M Tsutsumi
- Department of Urology, Hitachi General Hospital, Hitachi, Japan
| | - T Yokota
- Global Development, Shionogi & Co., Ltd, Osaka, Japan
| | - M Arai
- Global Development, Shionogi & Co., Ltd, Osaka, Japan
| | - Y Tada
- Global Development, Shionogi & Co., Ltd, Osaka, Japan
| | - M Narabayashi
- Department of Palliative Therapy, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - N Boku
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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Dakin H, Abel L, Burns R, Yang Y. Review and critical appraisal of studies mapping from quality of life or clinical measures to EQ-5D: an online database and application of the MAPS statement. Health Qual Life Outcomes 2018; 16:31. [PMID: 29433510 PMCID: PMC5810002 DOI: 10.1186/s12955-018-0857-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 01/29/2018] [Indexed: 11/17/2022] Open
Abstract
Background The Health Economics Research Centre (HERC) Database of Mapping Studies was established in 2013, based on a systematic review of studies developing mapping algorithms predicting EQ-5D. The Mapping onto Preference-based measures reporting Standards (MAPS) statement was published in 2015 to improve reporting of mapping studies. We aimed to update the systematic review and assess the extent to which recently-published studies mapping condition-specific quality of life or clinical measures to the EQ-5D follow the guidelines published in the MAPS Reporting Statement. Methods A published systematic review was updated using the original inclusion criteria to include studies published by December 2016. We included studies reporting novel algorithms mapping from any clinical measure or patient-reported quality of life measure to either the EQ-5D-3L or EQ-5D-5L. Titles and abstracts of all identified studies and the full text of papers published in 2016 were assessed against the MAPS checklist. Results The systematic review identified 144 mapping studies reporting 190 algorithms mapping from 110 different source instruments to EQ-5D. Of the 17 studies published in 2016, nine (53%) had titles that followed the MAPS statement guidance, although only two (12%) had abstracts that fully addressed all MAPS items. When the full text of these papers was assessed against the complete MAPS checklist, only two studies (12%) were found to fulfil or partly fulfil all criteria. Of the 141 papers (across all years) that included abstracts, the items on the MAPS statement checklist that were fulfilled by the largest number of studies comprised having a structured abstract (95%) and describing target instruments (91%) and source instruments (88%). Conclusions The number of published mapping studies continues to increase. Our updated database provides a convenient way to identify mapping studies for use in cost-utility analysis. Most recent studies do not fully address all items on the MAPS checklist. Electronic supplementary material The online version of this article (10.1186/s12955-018-0857-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Helen Dakin
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK.
| | - Lucy Abel
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, UK
| | - Richéal Burns
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Yaling Yang
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, UK
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Oh SH, Kim DK, Lee SU, Jung SH, Lee SY. Association between exercise type and quality of life in a community-dwelling older people: A cross-sectional study. PLoS One 2017; 12:e0188335. [PMID: 29216283 PMCID: PMC5720695 DOI: 10.1371/journal.pone.0188335] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/04/2017] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the effects of three major representative exercises (resistance, flexibility, and walking) on quality of life (QoL) in a population of community-dwelling older adults. MATERIALS AND METHODS This cross-sectional study used public data from the Sixth Korean National Health and Nutrition Examination Survey in 2014 (n = 1,586 older people). Demographic factors, three types of exercise, five EuroQoL subsets (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), and QoL scores (EQ-VAS) were investigated. The independent associations between each exercise and the five QoL subsets were determined using odds ratios (OR) adjusted for three demographic factors (age group, sex, and area of residence), using multivariate logistic regression analysis. RESULTS The EQ-VAS scores of the exercisers was significantly higher than those of the non-exercisers for all exercise types. Subjects with problems in mobility dimension performed less exercise of all types of than those with normal mobility (resistance: OR, 0.687; flexibility: OR, 0.733, and walking: OR, 0.489). The self-care dimension was independently correlated with flexibility (OR, 0.558) and walking (OR, 0.485). CONCLUSION All types of exercisers showed higher QoL scores than non-exercisers. Among the QoL dimensions, mobility and self-care were independently associated with flexibility and walking exercise in this older people, suggesting that engaging in regular flexibility and walking exercise is important for achieving higher QoL in the older people.
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Affiliation(s)
- Sang-Ho Oh
- Department of Physical Medicine & Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Don-Kyu Kim
- Department of Physical Medicine & Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Shi-Uk Lee
- Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Se Hee Jung
- Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Sang Yoon Lee
- Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
- * E-mail:
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Oh SH, Son SH, Kang SH, Kim DK, Seo KM, Lee SY. Relationship Between Types of Exercise and Quality of Life in a Korean Metabolic Syndrome Population: A Cross-Sectional Study. Metab Syndr Relat Disord 2017; 15:199-205. [DOI: 10.1089/met.2016.0151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sang Ho Oh
- Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Sun Han Son
- Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Si Hyun Kang
- Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Don-Kyu Kim
- Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Kyung Mook Seo
- Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Sang Yoon Lee
- Department of Physical Medicine and Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea
- Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
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Lawson R, Ryan J, King F, Goh JW, Tichy E, Marsh K. Cost Effectiveness of Naloxegol for Opioid-Induced Constipation in the UK. PHARMACOECONOMICS 2017; 35:225-235. [PMID: 27663572 DOI: 10.1007/s40273-016-0454-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVES Opioid-induced constipation (OIC) is the most common adverse effect reported in patients receiving opioids to manage pain. Initial treatment with laxatives provides inadequate response in some patients. Naloxegol is a peripherally acting µ-opioid receptor antagonist used to treat patients with inadequate response to laxative(s) (laxative inadequate responder [LIR]). A cost-effectiveness model was constructed from the UK payer perspective to compare oral naloxegol 25 mg with placebo in non-cancer LIR patients receiving opioids for chronic pain, and a scenario analysis of naloxegol 25 mg with rescue laxatives compared with placebo with rescue laxatives in the same patient population. METHODS The model comprised a decision tree for the first 4 weeks of treatment, followed by a Markov model with a 4-week cycle length and the following states: 'OIC', 'non-OIC (on treatment)', 'non-OIC (untreated)' and 'death'. Two phase III trials with a follow-up period of 12 weeks provided data on treatment efficacy, transition probabilities, adverse event frequency and patient utility. Resource utilisation data were sourced from a UK-based burden of illness study and physician surveys. A UK National Health Service and Personal Social Service perspective was adopted; costs and health-related quality of life gains were discounted at a rate of 3.5 %. The model was run over a time horizon of 5 years, reflecting the average period of opioid use. RESULTS Naloxegol has an incremental cost-effectiveness ratio of £10,849 per quality-adjusted life-year gained versus placebo, and £11,179 when rescue laxatives are made available in both arms (2014 values). Model outcomes were only sensitive to variations in utility inputs. However, the probabilistic sensitivity analyses indicate that naloxegol has a 91 % probability of being cost effective at a £20,000 threshold when compared with placebo. CONCLUSIONS Naloxegol is likely a cost-effective treatment option for LIR patients with OIC. This assessment should be supported by further work on the utility of patients with OIC, including how utility varies with more granular measures of OIC.
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Affiliation(s)
- Richard Lawson
- AstraZeneca Global Payer and Pricing (GPEP), 101 Orchard Ridge Drive, Gaithersburg, MD, 20878, USA
| | - James Ryan
- AstraZeneca Global Payer and Pricing (GPEP), Da Vinci Building, Melbourn Science Park, Hertfordshire, SG8 6EE, UK
| | - Frederic King
- AstraZeneca Global Payer and Pricing (GPEP), 101 Orchard Ridge Drive, Gaithersburg, MD, 20878, USA
| | - Jo Wern Goh
- Evidera Inc., 7101 Wisconsin Ave, Suite 1400, Bethesda, MD, 20814, USA
| | - Eszter Tichy
- Evidera Inc., Metro Building 6th Floor, 1 Butterwick, London, W6 8DL, UK
| | - Kevin Marsh
- Evidera Inc., Metro Building 6th Floor, 1 Butterwick, London, W6 8DL, UK.
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De Gregori M, Muscoli C, Schatman ME, Stallone T, Intelligente F, Rondanelli M, Franceschi F, Arranz LI, Lorente-Cebrián S, Salamone M, Ilari S, Belfer I, Allegri M. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach. J Pain Res 2016; 9:1179-1189. [PMID: 27994480 PMCID: PMC5153285 DOI: 10.2147/jpr.s115068] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Recently, attention to the lifestyle of patients has been rapidly increasing in the field of pain therapy, particularly with regard to the role of nutrition in pain development and its management. In this review, we summarize the latest findings on the role of nutrition and nutraceuticals, microbiome, obesity, soy, omega-3 fatty acids, and curcumin supplementation as key elements in modulating the efficacy of analgesic treatments, including opioids. These main topics were addressed during the first edition of the Study In Multidisciplinary Pain Research workshop: “FYD (Feed Your Destiny): Fighting Pain”, held on April 7, 2016, in Rome, Italy, which was sponsored by a grant from the Italian Ministry of Instruction on “Nutraceuticals and Innovative Pharmacology”. The take-home message of this workshop was the recognition that patients with chronic pain should undergo nutritional assessment and counseling, which should be initiated at the onset of treatment. Some foods and supplements used in personalized treatment will likely improve clinical outcomes of analgesic therapy and result in considerable improvement of patient compliance and quality of life. From our current perspective, the potential benefit of including nutrition in personalizing pain medicine is formidable and highly promising.
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Affiliation(s)
- Manuela De Gregori
- Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Study in Multidisciplinary Pain Research Group; Young Against Pain Group, Parma, Italy
| | - Carolina Muscoli
- Study in Multidisciplinary Pain Research Group; Department of Health Sciences, Institute of Research for Food Safety and Health, University "Magna Graecia" of Catanzaro, Parma, Italy; IRCCS San Raffaele Pisana, Roccelletta di Borgia, Catanzaro, Italy
| | - Michael E Schatman
- Study in Multidisciplinary Pain Research Group; US Pain Foundation, Bellevue, WA, USA
| | | | - Fabio Intelligente
- Study in Multidisciplinary Pain Research Group; Chronic Pain Service Anestesia Day-Surgery, IRCCS Humanitas Research Hospital, Rozzano
| | - Mariangela Rondanelli
- Study in Multidisciplinary Pain Research Group; Department of Public Health, Section of Human Nutrition and Dietetics, Azienda di Servizi alla Persona di Pavia, University of Pavia, Pavia
| | - Francesco Franceschi
- Study in Multidisciplinary Pain Research Group; Institute of Internal Medicine, Catholic University of Rome, Rome, Italy
| | - Laura Isabel Arranz
- Study in Multidisciplinary Pain Research Group; Department of Nutrition, Food Sciences and Gastronomy, University of Barcelona, Barcelona
| | - Silvia Lorente-Cebrián
- Study in Multidisciplinary Pain Research Group; Department of Nutrition, Food Science and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Maurizio Salamone
- Study in Multidisciplinary Pain Research Group; Metagenics Italia srl, Milano; Italian Lifestyle Medicine Association, Bari, Italy
| | - Sara Ilari
- Study in Multidisciplinary Pain Research Group; IRCCS San Raffaele Pisana, Roccelletta di Borgia, Catanzaro, Italy
| | - Inna Belfer
- Study in Multidisciplinary Pain Research Group; Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Massimo Allegri
- Study in Multidisciplinary Pain Research Group; Department of Surgical Sciences, University of Parma; Anesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliero, Universitaria of Parma, Parma, Italy
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