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Bowel Function Index Valid for Opioid-Induced Constipation

Three-item index is psychometrically valid, responsive to symptom severity

MONDAY, Nov. 23, 2015 (HealthDay News) — The Bowel Function Index (BFI) is a simple assessment tool for opioid-induced constipation, which is responsive to changes in symptom severity and has a threshold indicating constipation, according to consensus recommendations published online Nov. 19 in Pain Medicine.

Charles E. Argoff, M.D., from the Albany Medical Center in New York, and colleagues reviewed the literature relating to assessment methods used for opioid-induced constipation and utilized the nominal group technique to reach consensus on each objective. The following five assessment tools were evaluated: the Patient Assessment of Constipation-Symptoms (PAC-SYM), Patient Assessment of Constipation-Quality of Life (PAC-QOL), Stool Symptom Screener (SSS), Bowel Function Index (BFI), and Bowel Function Diary (BF-Diary).

The researchers found that the shortest tools were the three-item BFI and the four-item SSS, both of which were clinician administered. The BFI and 12-item PAC-SYM were most commonly used in published trials. In opioid-induced constipation, the 11-item BF-diary was highly relevant, and was developed and validated in accordance with U.S. Food and Drug Administration guidelines. The complex scoring for this tool and for the SSS, PAC-SYM, and 28-item PAC-QOL may render them impractical in clinical practice. The BFI was psychometrically validated and responsive to changes in symptom severity, with high scores indicative of greater severity. Scores above 28.8 points were indicative of constipation.

“The BFI is a simple assessment tool with a validated threshold of clinically significant constipation,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry; the study was partially funded by pharmaceutical companies and a health care communications company.

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