Year 2018 / Volume 110 / Number 11
Original
Prevalence of the need for sodium intake restriction and the use of laxatives in palliative patients

712-717

DOI: 10.17235/reed.2018.5432/2017

Álvaro Gándara del Castillo, María Herrera Abián, Cristina Vicente Martín, José María Fraile Vicente, Ruth Delgado Juárez,

Abstract
Background: palliative patients usually have diseases that require a restriction of dietary sodium, although the prevalence of this requirement is unknown. Such conditions, combined with constipation, may mean that the use of laxatives with electrolytes should be avoided. Objectives: to ascertain the prevalence of the need to restrict sodium intake in palliative patients and to analyze the prevalence of constipation and the use of laxatives, including those containing sodium. Method: this was a multicenter retrospective, descriptive, cross-sectional, epidemiological study of both inpatients and outpatients over 18 years of age treated at the palliative care clinic (June 2015-March 2016). Demographic and anthropometric characteristics, diseases associated with dietary sodium restriction and treatments administered were recorded. Results: the study sample consisted of 400 palliative patients, with a mean age of 77.8 ± 13.0 years and 52.2% were male. Of these, 68.3% were inpatients and 31.8% were outpatients. Comorbidities requiring low sodium or a sodium-free diet were found in 87.0% (95% CI: 83.3-90.0) of cases. Only 46.5% (95% CI: 41.5-51.5) of patients had been prescribed a low salt diet. It should be noted that 50.5% (95% CI: 45.5-55.5) of patients required a low sodium diet and suffered from constipation. Laxatives (polyethylene glycol or lactulose-rich products [PEG] with electrolytes in 54% of cases) were taken by 53.8% (95% CI: 48.7-58.7) of patients, 52.1% due to constipation and 42.3% as a prevention due to opioid treatment. Conclusions: a high proportion of the study cohort (87%) had some condition that required dietary sodium restriction and at least half the patients had constipation. The use of laxatives to treat or prevent constipation is common in palliative patients. A sodium-free laxative is therefore preferred in these patients.
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References
1 - Prichard D, Bharucha A. Management of opioid-induced constipation for people in palliative care. Int J Palliat Nurs 2015; 21(6): 272–280.
2 - Vargas Torres R, Palomo Iloro AI, García Rodrigo R, et al. Tratamiento y cuidados de enfermería en el estreñimiento del paciente paliativo. Medipal 2011; 18(3).
3 - Erichsen E, Milberg A, Jaarsma T, et al. Constipation in specialized palliative care: prevalence, definition, and patient-perceived symptom distress. J Palliat Med 2015.
4 - Erichsén E, Milberg A, Jaarsma T, et al. Constipation in specialized palliative care: factors related to constipation when applying different definitions. Support Care Cancer 2016; 24: 691.
5 - Sebastián Domingo JJ. Los nuevos criterios de Roma (IV) de los trastornos funcionales digestivos en la práctica clínica. Med Clin 2017.
6 - Candy B, Jones L, Goodman ML, Drake R, Tookman A. Laxatives or methylnaltrexone for the management of constipation in palliative care patients. Cochrane Database Syst Rev. 2011 Jan 19;(1):CD003448.
7 - Larkin PJ, Sykes NP, Centeno C, Ellershaw JE, Elsner F, Eugene B, et al. European Consensus Group on Constipation in Palliative Care. The management of constipation in palliative care: clinical practice recommendations. Palliat Med. 2008 Oct;22(7):796-807.
8 - Cordero M, Romero IM. Protocolo sobre el estreñimiento en una unidad de cuidados paliativos oncológicos. Nure Investigación. 2008, nº 35.
9 - Gonzales LK, Delmastro MA, Boyd DM, et al. Adjusting bowel regimens when prescribing opioids in women receiving palliative care in the acute care setting. Am J Hosp Palliat Care 2015.
10 - Candy B, Jones L, Larkin PJ, et al. Laxatives for the management of constipation in people receiving palliative care (Review). Cochrane Database of Systematic Reviews 2015; Issue 5. Art.
11 - Jarlbæk L1, Johnsen B, Hansen OB, et al. Treatment of constipation in palliative care patients is a challenge. Ugeskr Laeger 2016; 178(33).
12 - Ramkumar D, Rao S. Efficacy and safety of traditional medical therapies for chronic constipation: systematic review. American Journal of Gastroenterology 2005; 100: 936-71.
13 - Lee-Robichaud H, Thomas K, Morgan J, et al. Lactulose versus polyethylene glycol for chronic constipation. Cochrane Database Syst Rev 2010 Jul 7; (7): Art Nº: CD007570.
14 - Belsey JD, Geraint M, Dixon TA. Sistematic review and meta analysis: polyethylene glycol in adults with non-organic constipation. Int J Clin Pract 2010 Jun; 64(7): 944-55.
15 - European Consensus Group on Constipation in Palliative Care. The management of constipation in palliative care: clinical practice recommendations. Palliat Med 2008; 22: 796-807
16 - Wei L, Mackenzie IS, MacDonald TM, et al. Cardiovascular risk associated with sodium-containing medicines. Expert Opin Drug Saf 2014; 13(11): 1515-23.
17 - Page RL, O'Bryant CL, Cheng D, et al. Drugs that may cause or exacerbate heart failure: a scientific statement from the American Heart Association. Circulation 2016; 134
18 - García JP. Aporte de sodio por medicamentos. Su efecto sobre la presión arterial. Tendencias en Medicina 2012, 40(1)
19 - Polizzi D, Vesbianu D, Sawhney J. Estimated sodium content in prescription medication: Giving healthcare providers information on the estimated sodium content in prescription medications in an easy to use format. Therapeutics, Pharmacology and Clinical Toxicology 2012; 16 (2)
20 - Tafreshi J, Hoang TM , Grigorian T, et al. Impact of iatrogenic, excessive, nondietary sodium administration in patients with acute heart failure exacerbation on hospital length of stay. Pharmacotherapy 2011; 31(1): 58-61.
21 - Lloyd-Jones D, Adams RJ, Brown TM, et al. On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation 2010; 121: 46–215.
22 - Lindenfeld J, Albert NM, Boehmer JP, et al. Executive summary: HFSA 2010 comprehensive heart failure practice guideline. J Card Fail 2010; 16: 475–539
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Gándara del Castillo Á, Herrera Abián M, Vicente Martín C, Fraile Vicente J, Delgado Juárez R. Prevalence of the need for sodium intake restriction and the use of laxatives in palliative patients. 5432/2017


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Publication history

Received: 21/12/2017

Accepted: 22/05/2018

Online First: 26/07/2018

Published: 30/10/2018

Article revision time: 147 days

Article Online First time: 217 days

Article editing time: 313 days


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