Effectiveness of Laxatives in the Elderly - NIHR Health Technology ...

List of abbreviations ..................................... i
Executive summary ...................................... iii
1 Epidemiology of constipation in the
general adult population ............................. 1
Definition of constipation ............................. 1
Prevalence of constipation in the
general population ......................................... 1
Prevalence of constipation in
the elderly ....................................................... 2
Impact of constipation ................................... 4
Risk factors for constipation .......................... 5
2 Treatment of constipation .......................... 7
Use of laxatives in the elderly ........................ 7
Attitudes to defecation ................................... 8
Serious side-effects of laxative use ................. 8
Costs of laxatives ............................................. 9
3 Methods .......................................................... 15
Research questions for the current review .... 15
Sources ............................................................ 15
Inclusion/exclusion criteria .......................... 15
Study validity, data extraction,
and synthesis ................................................... 16
4 Results ............................................................ 17
Search results – previous
systematic reviews ........................................... 17
Studies of the prevention of constipation ..... 18
Contents
Health Technology Assessment 1997; Vol. 1: No. 13
RCTs of the effectiveness of laxatives in
treating constipation in the elderly ............... 20
Cost of laxatives .............................................. 30
Prevention and treatment of
faecal impaction ............................................. 30
5 Summary and research
recommendations ........................................ 33
Effective laxative treatments
for constipation ............................................... 33
Treatment of faecal impaction ....................... 33
Costs and cost-effectiveness of laxatives ........ 34
Conclusions and recommendations for
future research ................................................ 34
Acknowledgements ....................................... 37
References ..................................................... 39
Appendix 1 Search strategies ...................... 45
Appendix 2 Additional databases
searched .......................................................... 47
Appendix 3 Effect size by quality
score for adult trials identified by
Cochrane review ............................................ 49
Appendix 4 Excluded studies ...................... 51
Health Technology Assessment reports
published to date ......................................... 53