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Research Letter
Less Is More
August 2016

Pattern of Inpatient Laxative UseWaste Not, Want Not

Author Affiliations
  • 1Clinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montréal, Canada
  • 2Pharmacy Department, McGill University Health Centre, Montréal, Canada
  • 3Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada
JAMA Intern Med. 2016;176(8):1216-1217. doi:10.1001/jamainternmed.2016.2775

Constipation is common: present in up to 15% of healthy adults,1 39% of medical inpatients on admission, and develops over the course of hospitalization in 43%2 Given the frequency of bowel symptoms and provider diligence in treating constipation, laxative use in the hospital is common. While relatively inexpensive themselves, the indirect costs of laxatives include: pharmacy inventory management and distribution; nursing administration time; a contribution to polypharmacy; and downstream investigations (eg, Clostridium difficile testing) in the case of laxative-induced diarrhea. Evidence supporting the efficacy of certain laxatives is lacking, particularly docusate sodium/calcium,3 and so we quantified local patterns of laxative use, and estimated some of the associated costs.

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