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Fostering Best Practices for Reducing Opioid-Induced Constipation Using Technology.

KEY POINTS: Healthcareprovidersoftenneglect to initiateabowel regimen after prescribing opioid medication, potentially subjecting patients to opioid-induced constipation, one of the most serious side effects. The aimof this quality improvement projectwas to determine whether an intervention consisting of a combined opioid and bowel medication computerized order set, as well as education, would increase initiation of a bowel regimen within 24 hours of prescribing opioids. Patient medical charts, reviewed 2 weeks before and after order set implementation and 2 weeks after focus groups were conducted, revealed that a computerized intervention can change provider behavior. Further study on whether the intervention caused a decrease in the incidence of opioidinduced constipation is also warranted. PROBLEM DESCRIPTION In the United States, prescriptions for opioid analgesia increased from 149 million in 2003 to 245 million in 2014. Opioid-induced constipation (OIC) is by far the most common side effect for patients prescribed opioids. A consensus definition of OIC is: