Older people and laxative use: comparison between community and long-term care settings

Abstract

Constipation is a common problem affecting many older people's quality of life. The aim of the study was to describe and compare the frequency of use of laxative medication in Irish adults, aged 65 years and older, from the community and a long-term care setting. Participants (n=207) were part of the Irish ELDERMET project. The project aims to find out how diet and lifestyle influence, and are influenced by, the bacteria in the gut, and how this knowledge can be used to promote health in older Irish people. It has recruited over 450 people, aged 65 and older, and will use the information gathered from the extensive proforma to develop recommendations, as well as functional foods/functional food ingredients specifically designed to promote and support health in older populations. Data were collected between June 2008 and April 2010 using a survey questionnaire. A quantitative descriptive correlational design was used. Analysis was conducted using PASW Statistics 18.0. Participants in long-term care received a greater number of both laxatives and prescribed medications than community-dwelling participants. Increased polypharmacy was also seen in participants taking laxatives, with participants in long-term care significantly (p<0.001) more likely to take multiple laxatives. Nurses are in a key position to develop proactive approaches to the prevention and treatment of constipation.

Constipation and Laxative Use among Nursing Home Patients: Prevalence and Associations Derived from the Residents Assessment Instrument for Long-Term Care Facilities (interRAI LTCF)

“…Only number of drugs and ability to communicate remained significant risk factors in the adjusted analyses. The number of drugs as a risk factor for laxative use is found in several other studies [ 7 , 24 , 31 ]. Opiates were the only drug significantly associated with laxative use in the univariable analyses but lost significance in the adjusted analyses.…”

“…In this study 67.1% of the patients used laxatives regularly. Other studies have reported regular use of laxatives in NHs from 55.3% to 83.6% [ 7 , 24 , 31 , 61 , 62 ]. Only number of drugs and ability to communicate remained significant risk factors in the adjusted analyses.…”

“…Women are 2-3 times more likely to have constipation than men [ 3 , 4 ]. Between 17 and 40% of the community-dwelling older adults [ 5 – 7 ] and between 10 and 72% [ 8 – 11 ] of NH patients experience constipation.…”

Prevalence and Effectiveness of Laxative Use Among Elderly Residents in a Regional Hospital Affiliated Nursing Home in Hsinchu County

“…Although a better understanding of the etiology and pathophysiology of constipation in each resident is of the physicians’ responsibilities, in daily practice, registered nurses usually provide these treatments rather independently. Thus, nurses are in a key position to develop proactive approaches for preventing and treating the constipation (20). Increased involvement of the nursing staff by physicians and tailoring the treatment for individual residents could probably improve the outcome (12).…”

“…In the elderly, use of laxatives must be individualized with special attention to their medical history, drug interactions, costs, and side effects (9). Some studies have investigated the prevalence and associated factors of laxatives use or constipation symptoms among the nursing home elderly population (12, 13, 18, 20, 21). Though some studies reviewed the updated management of constipation and discussed the efficiency of individual laxatives (9, 11, 22), there are limited data on the effectiveness of laxative therapy among elderly nursing home residents (12).…”