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Addition of methadone to another opioid in the management of moderate to severe cancer pain: a case series
- Source :
- Journal of palliative medicine. 16(3)
- Publication Year :
- 2013
-
Abstract
- Previous research has reported improved pain after adding methadone to another opioid, but did not quantify this benefit using a validated outcome measure.To assess quantitatively the effectiveness of adding methadone to another opioid for moderate to severe cancer-related pain.All outpatients attending the Oncology Palliative Care Clinic from September 2010-September 2011, who had received methadone, were identified from pharmacy records. Inclusion criteria included: histological diagnosis of malignancy, age18 years, taking regular opioids and Edmonton Symptom Assessment System (ESAS) pain score ≥ 4.The primary outcome measure was a decrease in pain score of ≥ 2 points from methadone initiation to one-month follow-up (or closest available ESAS).Twenty patients were available for analysis, 16 of whom had neuropathic pain (80%). Eight patients (40%) had a decrease in pain score of ≥ 2 points at 1 month and a further 7 (35%) had a decrease of ≥ 2 points at the closest available time point. The mean pain score decreased from 7.7 +/- 1.8 to 5.2 +/- 2.4 from time of initiation to time of evaluation. The mean daily routine morphine equivalent, (excluding methadone), was 338 +/- 217.8 mg/day at initiation and 332 +/- 191 mg/day at evaluation; for methadone, mean doses at initiation and evaluation were 4.4 +/- 1.4 mg/day and 15.5 +/- 5.9 mg/day, respectively. Methadone was well tolerated in 17 patients (85%).The addition of methadone was associated with improved pain control for patients with moderate to severe pain on another opioid and appears to offer a safe, well-tolerated and practical alternative in this situation.
- Subjects :
- Male
medicine.medical_specialty
Palliative care
MEDLINE
Pain
Malignancy
Internal medicine
Neoplasms
medicine
Humans
General Nursing
Aged
Pain Measurement
Retrospective Studies
Aged, 80 and over
business.industry
Palliative Care
Retrospective cohort study
General Medicine
Middle Aged
medicine.disease
Analgesics, Opioid
Anesthesiology and Pain Medicine
Opioid
Neuropathic pain
Physical therapy
Female
Cancer pain
business
Methadone
medicine.drug
Subjects
Details
- ISSN :
- 15577740
- Volume :
- 16
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of palliative medicine
- Accession number :
- edsair.doi.dedup.....dfcd99e0ccf7db8b8acf7c5558949102