Surveying The Outcomes Of Lubiprostone (The STOOL Study) in Nursing Home Residents

• Reduce the number of oral medicines being taken by any nursing home resident from 9 or more to fewer than 9. (Quality Indicator Number 6) [ Time Frame: 60 days ] [ Designated as safety issue: No ]
• To compare the occurrence of fecal impaction during a 60-day period prior to initiating Lubiprostone with a 60 day period after initiating Lubiprostone. (Quality Indicator Number 11) [ Time Frame: 60 days ] [ Designated as safety issue: No ]
• To compare the occurrence of fecal incontinence during a 60-day period prior to initiating Lubiprostone with a 60 day period after initiating Lubiprostone. [ Time Frame: 60 days ] [ Designated as safety issue: No ]

The purpose is to assess the efficacy, clinical outcomes, and potential Quality Indicator benefits associated with the use of Lubiprostone in nursing home residents with a confirmed diagnosis of chronic idiopathic constipation.

The study is a prospective, observational, open-label, non-placebo, controlled study to measure the effects of Lubiprostone on CIC in nursing home residents. All clinical sites will follow a common protocol using standardizes definitions in which eligible patients will be asked to participate in the proposed study. During the course of the study, various selected parameters will be measured and compared to establish the clinical efficacy of Lubiprostone in the treatment of CIC.

The study sample (N=105) will be comprised of nursing home residents with a confirmed diagnosis of CIC. A power analysis generated a sample size of 97 residents. To protect the validity of the test, 8 residents were added to the final study sample to allow for losses to followup. Therefore, a final sample size of 105 residents was identified for the study.

Patients meeting the inclusion criteria will be recruited for participation in the study. 3 sites in Central Florida with multiple Nursing Homes per site will be recruited to participate in the proposed study.

Nursing Home Residents (adult subjects living in Nursing Homes)

Inclusion Criteria:

Patients must meet all of the following criteria to be eligible for the study:

• Adult men and women nursing home residents;
• Confirmed diagnosis of CIC using Rome criteria;
• Prescribed two or more laxatives, at recruitment;
• Taking 9 or more oral medicines (including prescription, OTC and prn)
• Free from conditions likely to be fatal within six months;
• Able to read or understand English; and
• Able and willing to provide informed consent or has a guardian/agent who can provide consent.

Exclusion Criteria:

• Currently pregnant;
• Presence of megacolon;
• Presence of rectal sigmoid cancer;
• Presence of colon cancer;
• Presence of anal incompetence;
• Conditions likely to be fatal within six months;
• Taking 8 or fewer medicines;
• Enrolled in hospice;
• Non-English speaking patients; and
• Unwilling or unable to provide informed consent and has no guardian/agent.
• Expected to be discharged within 3 months.