Constipation – prevalence and incidence among medical patients acutely admitted to hospital with a medical condition

Noiesen, Eline; Trosborg, Ingelise; Bager, Louise; Herning, Margrethe; Lyngby, Christel; Konradsen, Hanne

doi:10.1111/jocn.12511

Cited by 29 publications

(17 citation statements)

References 32 publications

(70 reference statements)

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“…We also detected a significant increase in senna use in both non-frail and frail patients after warfarin initiation. Constipation is a common problem in hospitalised elderly patients [41]. Senna increases bowel motility thereby potentially decreasing the absorption of vitamin K and resulting in elevated INR values [42].…”

Section: Discussionmentioning

confidence: 99%

Frailty and Co-Prescribing of Potentially Interacting Drugs in New Users of Warfarin

et al. 2020

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Background Warfarin is underutilised in frail older people because of the fear of bleeding complications. Drug interactions are an independent bleeding risk factor. However, the extent to which potential drug interactions are taken into account at warfarin therapy initiation in frail patients is not known. Objective The objective of this study was to investigate the use of potentially interacting drugs increasing the bleeding risk before and after warfarin initiation in frail and non-frail patients. Methods We conducted an observational study including inpatients aged ≥ 60 years initiated on warfarin in a tertiary hospital in Adelaide, South Australia. Frailty status was assessed with the Reported Edmonton Frail Scale. Medication charts were reviewed before and after warfarin initiation. Results In total, 151 patients (102 non-frail and 49 frail) were included. Before warfarin initiation, the use of clopidogrel and acetaminophen was more common in frail patients compared with non-frail patients (25.5% vs 10.2%, p = 0.0135, 63.8% vs 35.7% p = 0.0014, respectively). The use of non-steroidal anti-inflammatory drugs, 9.2% in non-frail patients and 6.4% in frail patients before warfarin initiation, was completely stopped after warfarin initiation in both groups. The use of antiplatelet drugs decreased from 56.1% in non-frail patients and 66.0 % in frail patients to 12.2% and 14.9%, respectively. Instead, the use of drugs affecting the metabolism of warfarin or vitamin K increased in both groups. No statistically significant difference was seen in the exposure to interacting drugs between study groups after warfarin initiation. Acetaminophen, senna glycosides and cytochrome P450 2C9 inhibiting drugs were the most common interacting drugs at discharge used in 49.0%, 18.4% and 20.4% of non-frail patients and 53.2%, 29.8% and 19.1% of frail patients, respectively. Conclusions The overall frequency of potential drug interactions was moderate and frail patients were not exposed to warfarin drug interactions more often than non-frail patients. Further studies in larger study populations are required to verify these results.

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Section: Discussionmentioning

confidence: 99%

Frailty and Co-Prescribing of Potentially Interacting Drugs in New Users of Warfarin

et al. 2020

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“…Using the strategy of wait and see and considering constipation a private challenge may also be related to not having discussed this issue during hospitalization. Other studies have found that prevalence and incidence are high, and often health-care professionals do not act until the problems are severe (Cardin et al, 2010 ; Noiesen et al, 2014 ; Rasmussen & Pedersen, 2010 ). On the one hand, this may be due to the fact that constipation remains difficult to talk about for both the patient and the nurse, like other bowel symptoms (Bliss et al, 2005 ; Cichowski et al, 2014 ) or other issues such as sexuality (Farrell & Belza, 2012 ) and spirituality (Molzahn & Sheilds, 2008 ).…”

Section: Discussionmentioning

confidence: 99%

“…A recent study identified symptoms of constipation in 44% of patients being admitted acutely to medical care unit. Furthermore, among those patients with no symptoms, 51% developed signs of constipation during the first 3 days of their hospital stay (Noiesen et al, 2014 ). Experiencing constipation during hospitalization tend to exacerbate the general well-being of the patients as well as prolonging the hospital stay (Harari, Martin, Buttery, O'Neill, & Hopper, 2007 ; Rasmussen & Pedersen, 2010 ; Trads & Pedersen, 2015 ).…”

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confidence: 99%

Living with constipation—older people's experiences and strategies with constipation before and during hospitalization

Munch

Tvistholm

Trosborg

et al. 2016

International Journal of Qualitative Studies on Health and Well

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BackgroundConstipation is a common problem among older people. This study aimed to explore how older patients experience constipation and which strategies they used in handling the condition before and during hospitalization.MethodsA qualitative exploratory research design was used. Fourteen semi-structured interviews were conducted with patients (61–91 years of age) during hospitalization. Data were analyzed by using content analysis.ResultsThemes concerning experiences were Bodily signs and symptoms of constipation; the participants described severe pain during constipation, as well as pronounced relief after bowel movements, Impact on well-being and social activities; being constipated negatively impacted their mood and limited social activities, Striving for bowel balance; the participants experienced an ongoing strive for balancing between constipation and diarrhea. Themes related to strategies were Struggling to find a solution; they were aware of different strategies to prevent and treat constipation, though the most common solution described was the use of laxatives, Wait and see; the participants were awaiting to take action until they experienced constipation symptoms, Constipation is a private problem being challenged during hospitalization; constipation was considered a private issue rarely discussed with health-care professionals.ConclusionThis study illuminates the need for health-care professionals to be attentive to this issue and initiate the conversation with patients in order to advise on the management of constipation.

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“…Of these older people, 43% developed signs of constipation during the first three days of their hospital stay (Noiesen et al . ).…”

Section: Introductionmentioning

confidence: 97%

Constipation is casting a shadow over everyday life – a systematic review on older people's experience of living with constipation

Tvistholm

Munch

Danielsen

2017

Journal of Clinical Nursing

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Constipation – prevalence and incidence among medical patients acutely admitted to hospital with a medical condition

Abstract: The study highlights the need to develop both clinical guidelines towards treating constipation, and preventive measures to ensure that patients do not become constipated while staying in hospital.

Cited by 29 publications

References 32 publications

Frailty and Co-Prescribing of Potentially Interacting Drugs in New Users of Warfarin

Frailty and Co-Prescribing of Potentially Interacting Drugs in New Users of Warfarin

Living with constipation—older people's experiences and strategies with constipation before and during hospitalization

Constipation is casting a shadow over everyday life – a systematic review on older people's experience of living with constipation

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