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
Median (IQR) | Agreement (%) | |
|---|---|---|
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 |