Assessment and management of constipation for patients receiving palliative care in specialist palliative care settings: a systematic review of the literature.

Deborah Muldrew, Felicity Hasson, Emma Carduff, Mike Clarke, Jo Coast, Anne Finucane, Lisa Graham, Philip Larkin, Noleen McCorry, Paul Slater, Max Watson, Eileen Wright, Sonja McIlfatrick

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

ABSTRACTBackground: Constipation is an important issue for patients receiving palliative care within specialist palliative care (SPC) settings. Questions and ambiguity, however, persists about international best practice and management. Aim: To synthesize the current evidence base on the assessment and management of constipation for palliative care patients within a SPC setting.Design: Systematic ReviewData Sources: MEDLINE, Embase, Cinahl, Scopus, and Cochrane databases were systematically searched in April 2017 for empirical studies, written in English, on the assessment and management of constipation in SPC settings, published between 2007 and 2017. Two researchers independently reviewed and critically appraised all studies, conducted data extraction and undertook a thematic analysis. Results: Thirteen studies were included in the review comprising randomised trials (n=3), observational (n=4), and descriptive studies (n=6). Most research was conducted in specialist palliative care units, targeting either healthcare professionals or patients. The analysis highlighted a lack of standard definition of constipation, raising questions on the existence and comparability of baseline prevalence figures, the physical and psychological impact on patients, resource impact on staff and service, the subjective and objective methods of assessing constipation, and key aspects of constipation management, including a lack of focus on non-pharmacological management in this setting.Conclusions: The results of this review are being used to inform the development of an educational intervention targeting health care professionals. Gaps in the evidence base include lack of consistent definition of constipation, constipation prevention, non-pharmacological management, and the consideration of the management of constipation for the dying patient.
LanguageEnglish
Pages1-9
JournalPalliative Medicine
VolumeOnline
Early online date12 Feb 2018
DOIs
Publication statusE-pub ahead of print - 12 Feb 2018

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Constipation
Palliative Care
Delivery of Health Care
Practice Management
Practice Guidelines
MEDLINE
Research Personnel
Databases
Psychology
Research

Keywords

  • Constipation
  • Assessment
  • Management
  • Palliative Care
  • Patients
  • Hospices
  • Systematic Review

Cite this

Muldrew, Deborah ; Hasson, Felicity ; Carduff, Emma ; Clarke, Mike ; Coast, Jo ; Finucane, Anne ; Graham, Lisa ; Larkin, Philip ; McCorry, Noleen ; Slater, Paul ; Watson, Max ; Wright, Eileen ; McIlfatrick, Sonja. / Assessment and management of constipation for patients receiving palliative care in specialist palliative care settings: a systematic review of the literature. In: Palliative Medicine. 2018 ; Vol. Online. pp. 1-9.
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Assessment and management of constipation for patients receiving palliative care in specialist palliative care settings: a systematic review of the literature. / Muldrew, Deborah; Hasson, Felicity; Carduff, Emma; Clarke, Mike; Coast, Jo; Finucane, Anne; Graham, Lisa; Larkin, Philip; McCorry, Noleen; Slater, Paul; Watson, Max; Wright, Eileen; McIlfatrick, Sonja.

In: Palliative Medicine, Vol. Online, 12.02.2018, p. 1-9.

Research output: Contribution to journalArticle

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AU - Muldrew, Deborah

AU - Hasson, Felicity

AU - Carduff, Emma

AU - Clarke, Mike

AU - Coast, Jo

AU - Finucane, Anne

AU - Graham, Lisa

AU - Larkin, Philip

AU - McCorry, Noleen

AU - Slater, Paul

AU - Watson, Max

AU - Wright, Eileen

AU - McIlfatrick, Sonja

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N2 - ABSTRACTBackground: Constipation is an important issue for patients receiving palliative care within specialist palliative care (SPC) settings. Questions and ambiguity, however, persists about international best practice and management. Aim: To synthesize the current evidence base on the assessment and management of constipation for palliative care patients within a SPC setting.Design: Systematic ReviewData Sources: MEDLINE, Embase, Cinahl, Scopus, and Cochrane databases were systematically searched in April 2017 for empirical studies, written in English, on the assessment and management of constipation in SPC settings, published between 2007 and 2017. Two researchers independently reviewed and critically appraised all studies, conducted data extraction and undertook a thematic analysis. Results: Thirteen studies were included in the review comprising randomised trials (n=3), observational (n=4), and descriptive studies (n=6). Most research was conducted in specialist palliative care units, targeting either healthcare professionals or patients. The analysis highlighted a lack of standard definition of constipation, raising questions on the existence and comparability of baseline prevalence figures, the physical and psychological impact on patients, resource impact on staff and service, the subjective and objective methods of assessing constipation, and key aspects of constipation management, including a lack of focus on non-pharmacological management in this setting.Conclusions: The results of this review are being used to inform the development of an educational intervention targeting health care professionals. Gaps in the evidence base include lack of consistent definition of constipation, constipation prevention, non-pharmacological management, and the consideration of the management of constipation for the dying patient.

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