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The Use of Methadone in Adult Patients with Cancer Pain at a Governmental Cancer Center in India

BACKGROUND: Management of cancer-related pain relies on the access to opioids. When regular opioids as morphine are not tolerated or are insufficient, adjuvant opioids as methadone are an affordable and effective analgesic. AIM: The aim of the project was to describe the pattern of use and clinical...

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Autores principales: Palat, Gayatri, Algotsson, Charlotte, Rayala, Spandana, Haridass, Vikranth, Nethagani, Jayalatha, Ahmed, Mustafa, Rapelli, Vineela, Medhin, Maria Gebre, Brun, Eva, Segerlantz, Mikael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121220/
https://www.ncbi.nlm.nih.gov/pubmed/34035632
http://dx.doi.org/10.4103/IJPC.IJPC_275_20
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author Palat, Gayatri
Algotsson, Charlotte
Rayala, Spandana
Haridass, Vikranth
Nethagani, Jayalatha
Ahmed, Mustafa
Rapelli, Vineela
Medhin, Maria Gebre
Brun, Eva
Segerlantz, Mikael
author_facet Palat, Gayatri
Algotsson, Charlotte
Rayala, Spandana
Haridass, Vikranth
Nethagani, Jayalatha
Ahmed, Mustafa
Rapelli, Vineela
Medhin, Maria Gebre
Brun, Eva
Segerlantz, Mikael
author_sort Palat, Gayatri
collection PubMed
description BACKGROUND: Management of cancer-related pain relies on the access to opioids. When regular opioids as morphine are not tolerated or are insufficient, adjuvant opioids as methadone are an affordable and effective analgesic. AIM: The aim of the project was to describe the pattern of use and clinical experiences of methadone in patients with cancer-related pain at a low-resource hospital in Hyderabad, one of few Indian cancer centers with permission to prescribe methadone. METHODS: Medical records of all patients who had been prescribed methadone, September 9, 2017 and November 19, 2019 were studied retrospectively. Data on analgesic treatment and opioid side effects were analyzed. RESULTS: A total of 93 adult cancer patients were included in the study. A majority of patients (79%) were prescribed opioid analgesic, mainly morphine, before methadone introduction. The initial daily dose of methadone ranged between 5 and 22.5 years and in the vast majority of the patients 5 mg, divided in two daily administrations. A good analgesic effect, with decreased pain, was reported in 60% of the patients. No severe side effects were reported. CONCLUSIONS: In this study, methadone as a primary opioid was used with a good analgesic effect for cancer pain in a low-resource setting. Indication for methadone was mainly uncontrolled pain with a regular opioid treatment. No severe adverse effects were reported. Further research and prospective studies are needed on methadone treatment in low-resource settings to establish the robust guidelines to support prescribing physicians.
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spelling pubmed-81212202021-05-24 The Use of Methadone in Adult Patients with Cancer Pain at a Governmental Cancer Center in India Palat, Gayatri Algotsson, Charlotte Rayala, Spandana Haridass, Vikranth Nethagani, Jayalatha Ahmed, Mustafa Rapelli, Vineela Medhin, Maria Gebre Brun, Eva Segerlantz, Mikael Indian J Palliat Care Original Article BACKGROUND: Management of cancer-related pain relies on the access to opioids. When regular opioids as morphine are not tolerated or are insufficient, adjuvant opioids as methadone are an affordable and effective analgesic. AIM: The aim of the project was to describe the pattern of use and clinical experiences of methadone in patients with cancer-related pain at a low-resource hospital in Hyderabad, one of few Indian cancer centers with permission to prescribe methadone. METHODS: Medical records of all patients who had been prescribed methadone, September 9, 2017 and November 19, 2019 were studied retrospectively. Data on analgesic treatment and opioid side effects were analyzed. RESULTS: A total of 93 adult cancer patients were included in the study. A majority of patients (79%) were prescribed opioid analgesic, mainly morphine, before methadone introduction. The initial daily dose of methadone ranged between 5 and 22.5 years and in the vast majority of the patients 5 mg, divided in two daily administrations. A good analgesic effect, with decreased pain, was reported in 60% of the patients. No severe side effects were reported. CONCLUSIONS: In this study, methadone as a primary opioid was used with a good analgesic effect for cancer pain in a low-resource setting. Indication for methadone was mainly uncontrolled pain with a regular opioid treatment. No severe adverse effects were reported. Further research and prospective studies are needed on methadone treatment in low-resource settings to establish the robust guidelines to support prescribing physicians. Wolters Kluwer - Medknow 2021 2021-02-17 /pmc/articles/PMC8121220/ /pubmed/34035632 http://dx.doi.org/10.4103/IJPC.IJPC_275_20 Text en Copyright: © 2021 Indian Journal of Palliative Care https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Palat, Gayatri
Algotsson, Charlotte
Rayala, Spandana
Haridass, Vikranth
Nethagani, Jayalatha
Ahmed, Mustafa
Rapelli, Vineela
Medhin, Maria Gebre
Brun, Eva
Segerlantz, Mikael
The Use of Methadone in Adult Patients with Cancer Pain at a Governmental Cancer Center in India
title The Use of Methadone in Adult Patients with Cancer Pain at a Governmental Cancer Center in India
title_full The Use of Methadone in Adult Patients with Cancer Pain at a Governmental Cancer Center in India
title_fullStr The Use of Methadone in Adult Patients with Cancer Pain at a Governmental Cancer Center in India
title_full_unstemmed The Use of Methadone in Adult Patients with Cancer Pain at a Governmental Cancer Center in India
title_short The Use of Methadone in Adult Patients with Cancer Pain at a Governmental Cancer Center in India
title_sort use of methadone in adult patients with cancer pain at a governmental cancer center in india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121220/
https://www.ncbi.nlm.nih.gov/pubmed/34035632
http://dx.doi.org/10.4103/IJPC.IJPC_275_20
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