Comparison of a novel methadone rotation method with other commonly used methods.

IF 2 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES BMJ Supportive & Palliative Care Pub Date : 2024-11-07 DOI:10.1136/spcare-2024-005147

Elaine Cunningham, Nicole DiBiagio, Florry O' Connell, Maedhbh Flannery, Michael Cronin, Marie Murphy, Mary Jane O'Leary, Fiona Kiely, Aoife C Lowney

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Abstract

Objectives: To compare a novel method of methadone rotation used in a specialist palliative care inpatient unit (SPCU) in Cork, Ireland, with rapid titration methods using Perth and Brisbane Protocols as well as the Edmonton method of methadone rotation.

Methods: A retrospective chart review was performed in March-June 2022. All patients who completed rotation to methadone during 2018-2019 in the SPCU were included. 2018-2019 was selected to study a population not affected by the coronavirus pandemic. Oral morphine equivalent (OME) was calculated using the opioid conversion chart. From the OME, the expected daily methadone dose was calculated using the Perth, Brisbane and Edmonton methods. These figures were then compared directly with the actual methadone doses achieved using our dosing schedule.

Results: A comparison of the expected doses using the Perth and Brisbane rapid titration protocols and stable daily dose achieved revealed that the stable methadone dose was significantly lower than both rapid titration protocols (p=<0.0001) and (p=0.0035, respectively). However, a comparison of the expected dose using the Edmonton method and the dose achieved did not determine any significant difference (p=0.7602).

Conclusions: This is the first evaluation of a novel Irish method of methadone rotation and demonstrates a lower overall daily methadone dose compared with established protocols.

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美沙酮轮换新方法与其他常用方法的比较。

目的比较爱尔兰科克姑息治疗专科住院病房（SPCU）使用的新型美沙酮轮换方法与使用珀斯和布里斯班协议的快速滴定方法以及埃德蒙顿美沙酮轮换方法：方法： 2022 年 3 月至 6 月进行了一次回顾性病历审查。纳入了所有在 2018-2019 年期间在 SPCU 完成美沙酮轮转的患者。选择2018-2019年是为了研究未受冠状病毒大流行影响的人群。口服吗啡当量（OME）使用阿片类药物换算表进行计算。根据口服吗啡当量，采用珀斯、布里斯班和埃德蒙顿方法计算出美沙酮的预期日剂量。然后，将这些数据与使用我们的给药计划所达到的美沙酮实际剂量进行直接比较：结果：将使用珀斯和布里斯班快速滴定方案计算出的预期剂量与获得的稳定日剂量进行比较后发现，稳定的美沙酮剂量明显低于两种快速滴定方案（p=结论：这是对爱尔兰美沙酮轮换新方法的首次评估，结果表明，与既定方案相比，美沙酮每日总剂量更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Supportive & Palliative Care Medicine-Medicine (miscellaneous)

CiteScore

4.60

自引率

7.40%

发文量

170

期刊介绍： Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance. We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication. In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.