RESEARCH QUESTIONS: How large was the proportion of patients remaining on long term methadone treatment after a switch from a strong opioid to methadone? How long had the patients been treated with opioids before the switch to methadone?
METHODS: Longitudinal pharmacoepidemiological study from the complete national Norwegian Prescription Database.
RESULTS: One hundred and thirty (77%) cancer patients received more than one dispensed prescription of methadone. Forty-nine (40%) chronic non-malignant pain (CNMP) patients continued to have methadone prescriptions dispensed more than 6 months after the switch. Of 168 cancer patients, 48 (29%) had tried two strong opioids prior to the switch to methadone whereas 21 (12.5%) had tried three or more strong opioids. Similar numbers for 124 CNMP patients were 26 (21%) and 34 (27%), respectively.
INTERPRETATION: Opioid switching to methadone appears to provide a long lasting improvement in pain control in a significant proportion of patients. However, the study raises concerns that treatment options with less risk are not being exhausted prior to switching to methadone.
- Forfattere: Fredheim, Olav Magnus; Husby, Kristin Moksnes; Borchgrevink, Petter Chr.; Skurtveit, Svetlana.
- Publisert: Palliative Medicine : A Multiprofessional Journal 2012 ;Volum 26.(6) s. 804-812. FHI NTNU STO UiO