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dc.contributor.author
Peirano, Gabriela P.
dc.contributor.author
Mammana, Guillermo
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Bertolino, Mariela
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Pastrana, Tania
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Vega, Gloria Fanny
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Russo, Jorgelina
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Varela, Gabriela
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Vignaroli, Ernesto
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Ruggiero, Raul Alejandro
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Armesto, Arnaldo Raúl
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Camerano, Gabriela Veronica
dc.contributor.author
Dran, Graciela Isabel
dc.date.available
2018-04-17T20:56:46Z
dc.date.issued
2016-08
dc.identifier.citation
Peirano, Gabriela P. ; Mammana, Guillermo; Bertolino, Mariela; Pastrana, Tania; Vega, Gloria Fanny; et al.; Methadone as first-line opioid treatment for cancer pain in a developing country palliative care unit; Springer; Supportive Care In Cancer; 24; 8; 8-2016; 3551-3556
dc.identifier.issn
0941-4355
dc.identifier.uri
http://hdl.handle.net/11336/42389
dc.description.abstract
Purpose: The use of methadone for cancer pain is limited by the need of expertise and close titration due to variable half-life. Yet, it is a helpful palliative strategy in low-resources countries given its long-acting effect at low cost and worth additional study. Our aim was to describe the prescription and outcomes of methadone as a first-line treatment for cancer pain in a tertiary palliative care unit (PCU) in Argentina. Methods: Retrospective review of medical records of patients with moderate to severe cancer pain seen at the PCU in 1-year period, who initiated strong opioids at the first consultation. Data collected during the first month of treatment included disease and pain characteristics, initial and final opioid type and dose and need for opioid rotation. Results: Methadone was the most frequent opioid both at the initial and last assessment (71 and 66 % of the prescriptions). In all, treatment with strong opioids provided considerable decrease in pain intensity (p < 0.001) with low and stable opioid dose. Median and interquartile range (IR) of oral morphine equivalent daily dose (OMEDD) was 26 (16–32) and 39 (32–55) mg for initial and final assessments, respectively (p = 0.3). In patients initiated with methadone, the median (IR) daily methadone dose was 5 (4–6) mg at first and 7.5 (6–10) mg at final assessment, and the median (IR) index of opioid escalation was 0 (0–4) mg; (p < 0.05). Patients on methadone underwent less percentage of opioid rotation (15 versus 50 %; p < 0.001) and longer time to rotation (20.6 ± 4.4 versus 9.0 ± 2.7 days; p < 0.001) than patients on other opioids. Conclusions: Results indicate the preference of methadone as first-line strong opioid treatment in a PCU, providing good pain relief at low doses with low need for rotation. Several considerations about the costs of strong opioids in the region are given.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Springer
dc.rights
info:eu-repo/semantics/restrictedAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
Cancer Pain
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Methadone
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First-Line Strong Opioid
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Developing Countries
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Medicina Critica y de Emergencia
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Medicina Clínica
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CIENCIAS MÉDICAS Y DE LA SALUD
dc.title
Methadone as first-line opioid treatment for cancer pain in a developing country palliative care unit
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2018-04-16T14:29:43Z
dc.journal.volume
24
dc.journal.number
8
dc.journal.pagination
3551-3556
dc.journal.pais
Alemania
dc.journal.ciudad
Berlin
dc.description.fil
Fil: Peirano, Gabriela P.. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; Argentina
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Fil: Mammana, Guillermo. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; Argentina
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Fil: Bertolino, Mariela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; Argentina
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Fil: Pastrana, Tania. University of Aachen; Alemania
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Fil: Vega, Gloria Fanny. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; Argentina
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Fil: Russo, Jorgelina. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; Argentina
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Fil: Varela, Gabriela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; Argentina
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Fil: Vignaroli, Ernesto. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; Argentina
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Fil: Ruggiero, Raul Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina
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Fil: Armesto, Arnaldo Raúl. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Farmacología; Argentina
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Fil: Camerano, Gabriela Veronica. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina
dc.description.fil
Fil: Dran, Graciela Isabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina
dc.journal.title
Supportive Care In Cancer
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1007/s00520-016-3191-5
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://link.springer.com/article/10.1007%2Fs00520-016-3191-5
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