Evidence map›Paper›PMID 40512185›Full record

ArticleClinical and translational gastroenterology2025

PAMORAs in Opioid-Induced Constipation: Are We Following the Guidelines?

Katie Liu, Ariana Chen, Pranav Rajaram, Grayson Buning, Allen A Lee, Prashant Singh

Abstract read
In one paragraph

Article in Clinical and translational gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Katie LiuDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.ORCID 0000-0001-7420-9905
Ariana Chen
Pranav Rajaram
Grayson Buning
Allen A Lee
Prashant Singh

Funding

A Systems Biology Approach Using Fecal Microbiota and Metabolomics to Identify Novel Subtypes in Irritable Bowel Syndrome.K23DK124567 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LEE, ALLEN A · 2021 to 2023
$729k
NIDDK NIH HHS K23 DK124567
6 · The paper itself

Abstract

introductionPeripherally acting u-opioid receptor antagonists (PAMORAs) are a safe and efficacious medication for treating opioid-induced constipation (OIC). This study evaluates the utilization of PAMORAs in patients with laxative-refractory OIC.

methodsPatients diagnosed with OIC from 2018 to 2023 were retrospectively identified at a tertiary care center. As recommended by the guidelines, patients were considered eligible for PAMORAs if they had failed at least 2 laxatives. Data on PAMORA prescription, demographics, clinical characteristics, and specialty of the managing provider were collected and analyzed using logistic regression and χ 2 analysis.

resultsOf 281 patients diagnosed with OIC, 204 (73%) were eligible for a PAMORA, of which only 58 (28%) were prescribed one. There were no differences in demographic or clinical characteristics between those who were offered PAMORAs vs not. There was a significant difference in prescribing patterns based on provider specialty ( P < 0.001). Although gastrointestinal (GI) specialists saw less than half of the eligible patients, they offered PAMORAs at the highest proportion of 59% compared with non-GI specialists (13-16%) or primary care providers (18%). Multivariable logistic regression analysis showed 12.7-fold increased odds of being offered a PAMORA if the provider was from the GI department compared with all non-GI providers ( P < 0.001). DISCUSSION: PAMORAs are underutilized in patients with OIC. GI prescribers offer PAMORAs at a higher proportion than other departments, and being seen in GI independently increases the likelihood of a patient receiving a PAMORA. This suggests that underutilization may be due to a lack of awareness and further education about PAMORAs is warranted.

Indexed as

Analgesics, OpioidConstipationGuideline AdherenceNarcotic AntagonistsOpioid-Induced ConstipationPractice Patterns, Physicians'AdultAgedFemaleHumansLaxativesMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesTertiary Care CentersAnalgesics, OpioidLaxativesNarcotic Antagonistslaxativesopioid-induced constipationperipherally acting mu opioid receptor antagonists

Identifiers

PMID40512185
PMCPMC12377320

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.