{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:55:23Z","timestamp":1777859723263,"version":"3.51.4"},"reference-count":7,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2022,4]]},"abstract":"\n Background:<\/jats:title>\n Opioid-induced constipation (OIC) treatment guidelines recommend over-the-counter laxatives as first-line therapy, followed by treatment with a peripherally-acting mu-opioid receptor antagonist (PAMORA) in refractory patients.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To evaluate the ability of a pharmacist-driven OIC protocol to promote increased scheduled laxative use prior to escalation to PAMORA therapy.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This retrospective, single-center cohort study evaluated patients 2 years pre- and post-protocol implementation. The primary outcome was the difference in the percentage of patients receiving 2 scheduled laxatives for \u2265 2 days prior to PAMORA therapy pre- and post-protocol. Secondary outcomes included difference in time to first bowel movement after PAMORA initiation, difference in total number of laxative\/PAMORA doses administered, and difference in overall estimated total cost. Data was analyzed using chi-squared tests and Student\u2019s t tests.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Three-hundred patients were included (150 patients in the pre and post-protocol groups). In the pre-protocol group, 53 patients (35%) received 2 scheduled laxatives for 2 days prior to naloxegol\/methylnaltrexone compared to 96 patients (64%) in the postprotocol group (p < 0.0001). One-thousand twenty-one scheduled laxative doses were given pre-protocol versus 1625 doses post-protocol. Average time to first bowel movement was similar between groups (17.7 hours vs 16.0 hours p = 0.441). Estimated total cost of OIC reversal therapy decreased from $20,896.95 to $13,405.47.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n A pharmacist-driven OIC protocol is associated with an increase in the use of scheduled laxatives prior to PAMORA administration and decreased overall estimated total cost. A larger, prospective study is necessary to assess if this promotes more efficacious OIC.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/0897190020966203","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T06:59:38Z","timestamp":1602658778000},"page":"218-222","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of a Pharmacist-Driven Protocol for the Treatment of Opioid-Induced Constipation"],"prefix":"10.1177","volume":"35","author":[{"given":"Alexander R.","family":"Tryson","sequence":"first","affiliation":[{"name":"Mercy Hospital St. Louis, Saint Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin K.","family":"Hennessey","sequence":"additional","affiliation":[{"name":"St. Louis College of Pharmacy\/Mercy Hospital St. Louis, Saint Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8898-1493","authenticated-orcid":false,"given":"Andrew J.","family":"Crannage","sequence":"additional","affiliation":[{"name":"St. Louis College of Pharmacy\/Mercy Hospital St. Louis, Saint Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,10,14]]},"reference":[{"key":"bibr1-0897190020966203","unstructured":"Centers for Disease Control and Prevention. U.S. Opioid Prescribing Rate Maps. Published July 6, 2017. Updated March 5, 2020. Accessed August 18, 2020. https:\/\/www.cdc.gov\/drugoverdose\/maps\/rxrate-maps.html"},{"key":"bibr2-0897190020966203","doi-asserted-by":"publisher","DOI":"10.1177\/2040622315627801"},{"key":"bibr3-0897190020966203","doi-asserted-by":"publisher","DOI":"10.1177\/1756283X15578608"},{"key":"bibr4-0897190020966203","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/141737"},{"key":"bibr5-0897190020966203","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S61602"},{"key":"bibr6-0897190020966203","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.07.016"},{"issue":"12","key":"bibr7-0897190020966203","first-page":"15","volume":"42","author":"Gregorian T","year":"2017","journal-title":"US Pharm"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190020966203","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0897190020966203","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190020966203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:36:20Z","timestamp":1777509380000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0897190020966203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,14]]},"references-count":7,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1177\/0897190020966203"],"URL":"https:\/\/doi.org\/10.1177\/0897190020966203","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,14]]}}}