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Table 1 Agreement achieved by the experts after the two rounds (Topic 1)

From: Delphi consensus on strategies in the management of opioid-induced constipation in cancer patients

Topic 1. Diagnosis of OIC
1. OIC is defined as: “a change in previous bowel habits when opioid treatment is initiated or modified that is characterized by any of the following conditions: decreased frequency of spontaneous bowel movements, straining of stools, feeling of incomplete bowel movements, harder stools, perception of patient involvement in relation to bowel habits. 8 (1) 95.75
2. The use in clinical practice of the ROME IV criteria may contribute to improve the differential diagnosis of OIC in cancer patients. 8 (2) 82.97
3. The use of the Bowel Function Index (BFI) questionnaire in daily clinical practice would facilitate the diagnosis of OIC. 8 (2) 74.47
4. The comprehensive approach to OIC is different in oncology patients from that of non-oncology patients. 8 (2) 90.00
5. OIC is a common problem among cancer patients in routine clinical practice 8 (1) 87.24
6. There are a large number of patients with cancer affected by OIC in which a correct diagnosis of this condition is not made. 8 (2) 85,1
7. For an effective approach to OIC, it must be remembered, both at the time of prescription and throughout treatment, that opioids can cause constipation. 9 (1) 100.00
8. It is recommended to educate patients on OIC (causes, symptoms, management, etc.) when receiving opioid treatment. 9 (1) 97.88
9. It is recommended that healthcare professionals proactively ask patients under opioid treatment about the symptoms of OIC in order to improve this condition. 9 (1) 100.00
10. Occasionally, patients only report symptoms of OIC to the physician when these are severe. 8 (2) 85.11
11. At the time of opioid treatment it is important to know the presence of previous functional constipation (constipation caused by causes other than opioids). 8 (1) 93.62
12. When OIC coexists with other causes of constipation, the symptoms of OIC are exacerbated. 8 (1) 89.37
13. For the effective diagnosis of OIC, a complete patient clinical history (including previous history, pharmacological treatments, metabolic alterations...) is needed to help differentiate OIC from functional constipation. 9 (1) 95.75
14. For the effective diagnosis of OIC, it is essential to evaluate the temporal relationship between the onset of opioid use and the development of OIC symptoms. 8 (2) 89.36
15. For the effective diagnosis of OIC in oncological patients, a physical examination is essential to rule out possible organic problems that could be the origin of the symptoms, such as intestinal obstruction. 8 (1) 89.37
16. At the time of diagnosis of OIC, it is essential to evaluate the presence of faecal impaction. 8 (2) 78.72
17. In routine clinical practice, requests for additional tests are necessary only if other causes of constipation are suspected. 8 (1) 80.84
  1. IQR interquartile range, OIC opioid-induced constipation