Comparing Methadone Rotation to Consensus Opinion.
J Pain Symptom Manage
; 59(1): 116-120, 2020 01.
Article
in En
| MEDLINE
| ID: mdl-31560968
ABSTRACT
CONTEXT Methadone is a complex but useful medication for pain management in palliative care. Recent expert opinions have been published on the safe and effective use of methadone. OBJECTIVES:
To determine the success of methadone rotations and evaluate concordance with consensus recommendations by a palliative care consult service.METHODS:
A retrospective study of methadone rotation practice by a palliative care consult service and outcomes for patients hospitalized between January 1, 2012 and December 31, 2018 at a single academic medical center. A successful rotation was defined as a 30% reduction in pain or as-needed medication use sustained for at least three consecutive days. Patient outcomes were compared with expert consensus recommendations.RESULTS:
About 59 patients met the inclusion criteria. The study population was mostly Caucasian men and women of equal proportions who were started on methadone for inadequate pain control. Sixty-eight percent of patients were successfully rotated. Subjects who were rotated using a standardized protocol were six times more likely to have a successful rotation (odds ratio 6.28 [1.25-30.92]; P = 0.0238).CONCLUSION:
The utilization of a standardized protocol was associated with better patient outcomes.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pain
/
Pain Management
/
Analgesics, Opioid
/
Methadone
Type of study:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Pain Symptom Manage
Journal subject:
NEUROLOGIA
/
PSICOFISIOLOGIA
/
TERAPEUTICA
Year:
2020
Type:
Article