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The use of Methadone in adult patients with cancer-pain at a governmental cancer centre in India

Palat, Gayatri ; Algotsson, Charlotte LU ; Rayala, Spandana ; Haridass, Vikranth ; Nethagani, Jaya ; Mustafa, Ahmed ; Rapelli, Vineela ; Gebre-Medhin, Maria LU ; Brun, Eva LU and Segerlantz, Mikael LU (2021) In Indian Journal of Palliative Care 27(1). p.139-145
Abstract
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... (More)
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. (Less)
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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
methadone, Cancer-pain, India
in
Indian Journal of Palliative Care
volume
27
issue
1
pages
139 - 145
publisher
Wolters Kluwer
external identifiers
  • scopus:85102003264
  • pmid:34035632
ISSN
0973-1075
DOI
10.4103/IJPC.IJPC_275_20
language
English
LU publication?
yes
id
dcd8691e-0ac6-442d-af00-11eefbe37616
date added to LUP
2021-04-30 10:08:52
date last changed
2024-05-18 09:02:40
@article{dcd8691e-0ac6-442d-af00-11eefbe37616,
  abstract     = {{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.}},
  author       = {{Palat, Gayatri and Algotsson, Charlotte and Rayala, Spandana and Haridass, Vikranth and Nethagani, Jaya and Mustafa, Ahmed and Rapelli, Vineela and Gebre-Medhin, Maria and Brun, Eva and Segerlantz, Mikael}},
  issn         = {{0973-1075}},
  keywords     = {{methadone; Cancer-pain; India}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{1}},
  pages        = {{139--145}},
  publisher    = {{Wolters Kluwer}},
  series       = {{Indian Journal of Palliative Care}},
  title        = {{The use of Methadone in adult patients with cancer-pain at a governmental cancer centre in India}},
  url          = {{http://dx.doi.org/10.4103/IJPC.IJPC_275_20}},
  doi          = {{10.4103/IJPC.IJPC_275_20}},
  volume       = {{27}},
  year         = {{2021}},
}