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Cited by 35Gastrointestinal motility and disordersPharmaceutical Practices and Patient OutcomesGeriatric Care and Nursing Homes

Constipation and laxative use among people living in nursing homes in 2007 and 2013

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Gustafsson, Maria, Lämås, Kristina, Isaksson, Ulf, Sandman, Per-Olof, Lövheim, Hugo·2019·BMC Geriatrics
DOI 10.1186/s12877-019-1054-xPMC PMC6368797
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Abstract

BACKGROUND: Constipation is a common condition among older people, particularly among people living in nursing homes, and the use of drugs such as opioids is one of many factors that contribute to its high prevalence. The aim of this study was to compare the prevalence of constipation and the use of laxatives between 2007 and 2013, to analyze constipation and laxative use among people who are prescribed opioids, and to identify factors associated with constipation. METHODS: In 2007 and 2013, two surveys were performed in the county of Västerbotten in Northern Sweden, comprising all those living in nursing homes. The Multi-Dimensional Dementia Assessment Scale was used to collect data regarding laxative, opioid and anticholinergic drug use, functioning in activities of daily living (ADL), cognition and symptoms of constipation. A comparison was made between 2820 people from 2007 and 1902 people from 2013. RESULTS: The prevalence of symptoms of constipation among people living in nursing homes increased from 36% in 2007 to 40% in 2013. After controlling for age, sex, ADL, cognitive impairment and use of opioid and anticholinergic drugs, this difference was found to be statistically significant. When controlled for demographic changes, there was a statistically significant difference in the regular use of laxatives between the respective years, from 46% in 2007 to 59% in 2013. People prescribed opioids and anticholinergic drugs were at increased risk of constipation, while people with a higher ADL score were at decreased risk. Further, among people prescribed opioids and rated as constipated, 35% in 2007 and 20% in 2013 were not prescribed laxatives for regular use, a difference that was found to be statistically significant. CONCLUSIONS: The prevalence of symptoms of constipation increased between 2007 and 2013. Although there was a decrease between the years, there were still a number of people being prescribed with opioids and rated as constipated who were not treated with laxatives. This study therefore indicates that constipation remains a significant problem among people in nursing homes and also indicates that those prescribed opioids could benefit from an increased awareness of the risk of constipation and treatment, if required.

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  • Around 50% of residents in LTCF have constipation and 70% of them need laxative agents.

    “Studies have shown that around 50% of residents in LTCF have constipation and 70% of them need laxative agents (1, 2).”

    From Effectiveness of Partially Hydrolyzed Guar Gum in Reducing Constipation in Long Term Care Facility Residents: A Randomized Single-Blinded Placebo-Controlled Trial (2022) · cites this paper as [1]

    The Results report constipation symptoms in 36% of nursing-home residents in 2007 and 40% in 2013, rather than around 50% overall. Results Table 5 finds about 48% constipation and 72% laxative prescribing in the subgroup prescribed opioids, but those figures cannot establish that 70% of all constipated residents need laxatives. Page numbers are unavailable in our copy. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Gustafsson, M., Lämås, K., Isaksson, U., Sandman, P.-O., & Lövheim, H.
Affiliations
  • Umeå University (SE)
  • Arctic Research Centre (SE)
  • Karolinska Institutet (SE)
Corresponding author
Gustafsson, Maria
ORCID
Venue
BMC Geriatrics
Publisher
Springer Science and Business Media LLC
Published
2019-02-08
Volume
19
Issue
1
Pages
38-38
ISSN
1471-2318 (ISSN-L)
DOI
10.1186/s12877-019-1054-x
PMC
PMC6368797
OpenAlex
W2916970107
Cited by
35
References
1
Citations by year
2026: 4 · 2025: 3 · 2024: 3 · 2023: 10 · 2022: 6 · 2021: 5 · 2020: 4
FWCI
3.32
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Geriatrics (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DiVA at Umeå University (Umeå University) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Swedish Brain Power
  • Demensförbundet
  • Västerbotten Läns Landsting
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Keywords
constipation, laxative use, nursing home residents, older adults, opioid use, anticholinergic agents, activities of daily living, cognitive impairment, prevalence trends, drug-induced constipation
MeSH terms
Activities of Daily Living, Aged, Aged, 80 and over, Analgesics, Opioid, Constipation, Female, Humans, Male, Nursing Homes, Surveys and Questionnaires, Sweden, Laxatives, Cognitive Dysfunction

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