Hawley, P.H., & Byeon, J.J. (2008). A comparison of sennosides-based bowel protocols with and without docusate in hospitalized patients with cancer. Journal of Palliative Medicine, 11, 575–581.doi: 10.1089/jpm.2007.0178
To determine the efficacy of sennoside-based regimens on the proportion of total days with at least one bowel movement (BM) per day.
During phase I, the first 30 consecutive eligible patients admitted to the ward received docusate plus sennosides (DS) for management of constipation. Dosing was as follows.
During phase II, the next 30 eligible patients with constipation received sennosides only. Dosing was as follows.
Rescue laxatives included lactulose, a suppository, or enema as needed. Only 12 days of bowel protocol were abstracted from the medical record.
This was a nonrandomized, nonblinded, sequential cohort study.
Nursing chart review
Sennosides only produced more BMs than DS.
Adding a stool softener such as docusate does not necessarily produce superior results than those seen with a laxative alone. However, additional randomized, double-blind studies should be conducted before conclusions and evidence into practice are drawn. The usefulness of this study is questionable because of its design and execution issues.