You are here

  • Home
  • Archive
  • Volume 13, Issue e3
  • Methadone prescribed as an analgesic by a specialist palliative medicine team in an acute hospital inpatient setting: retrospective study

Article Text

Article menu
Download PDFPDF
Short report
Methadone prescribed as an analgesic by a specialist palliative medicine team in an acute hospital inpatient setting: retrospective study
  1. Jennifer Hayes1,
  2. Dympna Waldron1,2,
  3. Kirk J Levins3,4,
  4. Laura Gaffney1,
  5. Mahrukh Azhar1,
  6. Sharon Beatty1,2 and
  7. Eileen Mannion1,2
  1. 1 Department of Palliative Medicine, Galway University Hospital, Saolta Hospitals Group, Galway, Ireland
  2. 2 Department of Medicine, The College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
  3. 3 Department of Pain Medicine, St Vincent's University Hospital, Dublin, Ireland
  4. 4 Department of Clinical Medicine, University College Dublin, Dublin, Ireland
  1. Correspondence to Dr Jennifer Hayes, Department of Palliative Medicine, Galway University Hospital, Saolta Hospitals Group, Galway, Ireland; jhayes2{at}gmail.com

Abstract

Emerging evidence suggests that methadone has a specific role in the management of treatment resistant cancer-related pain.

Objectives To investigate the utilisation pattern, safety and efficacy of methadone prescribed as an analgesic for the management of complex cancer-related pain in an acute hospital inpatient setting.

Methods A retrospective longitudinal observational study of patients prescribed methadone as an analgesic between April 2020 and July 2021 was performed.

Changes in coprescribed baseline opioid, use of breakthrough opioid analgesic, patient rated pain scores and adverse side effects were analysed.

Results 16 patients with complex cancer-related treatment resistant pain who were prescribed methadone were included in the study. Of the 16 patients, 14 patients had metastatic disease. Pain was classified in 14 patients as mixed nociceptive-neuropathic and in 2 patients as neuropathic. 13 patients were coprescribed methadone with a pre-established opioid. Methadone was associated with a statistically significant decrease in both opioid breakthrough analgesic by 61%±28% (p<0.001), and coprescribed opioid by 17%±12% (p=0.015). Patient rated pain scores were also significantly decreased (p<0.001).

Conclusion Methadone appears to have a specific role in the management of complex cancer pain, neuropathic pain, opioid-tolerance and opioid-induced hyperalgesia, which may be attributable to N-methyl-D-aspartate receptor antagonism.

  • Pharmacology
  • Renal failure
  • Cancer
  • Drug administration
  • Pain

https://doi.org/10.1136/spcare-2022-003586

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Twitter @DrJHayes2

    • Contributors JH: main author, designed methodology, conducted literature review, data collection and data analysis, initial draft, edited final document and did revisions to address reviewers comments. DW: principal investigator, supervised JH, co-authored draft, edited final document and did revisions to address reviewers’ comments. KJL: edited final document and did revisions to address reviewers comments.

      LG-contributed to ketamine data.

      Proof-read document: LG, MA, SB and EM.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.