Abstract / Summary
Constipation is common among hospitalized patients with cancer and may adversely affect their quality of life as well as the continuation of their anticancer treatment. The Constipation Risk Assessment Scale (CRAS), developed in the United States, has been reported to demonstrate favorable content validity, predictive validity, and interrater reliability in China. To our knowledge, there have been no reports of CRAS use in Japan; therefore, beginning in January 2022, pharmacists at our hospital initiated the use of the Japanese version, CRAS-J, on admission for hospitalized patients with cancer. Constipation was defined as the occurrence of “no bowel movement for 2 consecutive days” within 7 days of hospital admission. To evaluate the usefulness and predictive validity of CRAS-J, bowel management outcomes were compared before and after its introduction. This retrospective study reviewed the medical records of eligible cancer inpatients admitted during the pre-introduction period (January 2020 – December 2021) and the post-introduction period (January 2022 – June 2024). No significant differences in patient background characteristics were observed between the two periods. The incidence of constipation decreased significantly after the introduction of CRAS-J [60/85 cases (70.6％) before introduction vs 44/83 cases (53.0％) after introduction; P = 0.026]. Furthermore, the mean CRAS-J score was significantly higher in the “constipation present” group (n = 44; 15.25) than in the “constipation absent” group (n = 39; 12.97) (P = 0.012). These findings support the usefulness of CRAS-J for improving bowel management in hospitalized patients with cancer and suggest that the CRAS-J score may serve as one indicator of early constipation after admission.