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Drug-Induced Constipation-Reply

Drug-Induced Constipation-Reply Abstract We agree with the comments by Lisi on the lack of a "gold standard" in evaluating constipation. For this reason, we choose the treatment of the disorder, through the use of laxatives, as the case definition for the study outcome, on the grounds that people with constipation are much more likely to be given laxatives than those without constipation.1 Only doses actually administered, not scheduled, or as occasion requires were used in the analysis. We attempted to control for the possible confounders in this study through measuring mobility with an activities of daily living scale and mental status through the Folstein Mini-Mental State Examination. As correctly pointed out, we were unable to control for diet, motility disorders, and inflammation. Nonetheless, there is no reason to expect that these variables were differentially distributed among patients and control subjects. In fact, it is more likely that these factors were nondifferentially distributed, References 1. Monane M, Avorn J, Beers MH, Everitt DE. Anticholinergic drug use and bowel function in nursing home patients . Arch Intern Med. 1993;153:633-638.Crossref 2. Rothman KJ. Modern Epidemiology . Boston, Mass: Little Brown & Co Inc; 1986. 3. Buck JA. Psychotropic drug practice in nursing homes . J Am Geriatr Soc. 1989; 36:409-418. 4. Avorn J, Soumerai SB, Everitt DE, et al. A randomized controlled trial of a program to reduce the use of psychoactive drugs in nursing homes . N Engl J Med. 1992;327:168-173.Crossref 5. Beers MH, OuslanderJG, Rollingher 1, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents . Arch Intern Med. 1991;151:1825-1832.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1994.00420040143020
Publisher site
See Article on Publisher Site

Abstract

Abstract We agree with the comments by Lisi on the lack of a "gold standard" in evaluating constipation. For this reason, we choose the treatment of the disorder, through the use of laxatives, as the case definition for the study outcome, on the grounds that people with constipation are much more likely to be given laxatives than those without constipation.1 Only doses actually administered, not scheduled, or as occasion requires were used in the analysis. We attempted to control for the possible confounders in this study through measuring mobility with an activities of daily living scale and mental status through the Folstein Mini-Mental State Examination. As correctly pointed out, we were unable to control for diet, motility disorders, and inflammation. Nonetheless, there is no reason to expect that these variables were differentially distributed among patients and control subjects. In fact, it is more likely that these factors were nondifferentially distributed, References 1. Monane M, Avorn J, Beers MH, Everitt DE. Anticholinergic drug use and bowel function in nursing home patients . Arch Intern Med. 1993;153:633-638.Crossref 2. Rothman KJ. Modern Epidemiology . Boston, Mass: Little Brown & Co Inc; 1986. 3. Buck JA. Psychotropic drug practice in nursing homes . J Am Geriatr Soc. 1989; 36:409-418. 4. Avorn J, Soumerai SB, Everitt DE, et al. A randomized controlled trial of a program to reduce the use of psychoactive drugs in nursing homes . N Engl J Med. 1992;327:168-173.Crossref 5. Beers MH, OuslanderJG, Rollingher 1, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents . Arch Intern Med. 1991;151:1825-1832.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 28, 1994

References