Conversion of other opioids to methadone: a retrospective comparison of two methods.

Lukin, B; Greenslade, J; Kearney, AM; Douglas, C; Howell, T; Barras, M; Good, P

Conversion of other opioids to methadone: a retrospective comparison of two methods.

Lukin, B Greenslade, J Kearney, AM Douglas, C Howell, T Barras, M Good, P

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Publisher:: BMJ PUBLISHING GROUP
Publication Type:: Journal Article
Citation:: BMJ supportive & palliative care, 2020, 10, (2), pp. 201-204
Issue Date:: 2020

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Field	Value	Language
dc.contributor.author	Lukin, B
dc.contributor.author	Greenslade, J
dc.contributor.author	Kearney, AM
dc.contributor.author	Douglas, C
dc.contributor.author	Howell, T
dc.contributor.author	Barras, M
dc.contributor.author	Good, P https://orcid.org/0000-0002-8198-0375
dc.date.accessioned	2020-08-07T00:48:09Z
dc.date.available	2019-01-23
dc.date.available	2020-08-07T00:48:09Z
dc.date.issued	2020
dc.identifier.citation	BMJ supportive & palliative care, 2020, 10, (2), pp. 201-204
dc.identifier.issn	2045-435X
dc.identifier.issn	2045-4368
dc.identifier.uri	http://hdl.handle.net/10453/142005
dc.description.abstract	CONTEXT:A rapid method of methadone conversion known as the Perth Protocol is commonly used in Australian palliative care units. There has been no follow-up or validation of this method and no comparison between different methods of conversion. OBJECTIVES:The primary objective of this study was to test the hypothesis that the achieved doses of methadone are independent of the conversion method (rapid vs slower). The secondary objectives included examining the relationship between calculated target doses, actual achieved doses and duration of conversions. METHODS:This is a retrospective chart audit conducted at two hospital sites in the Brisbane metropolitan area of Australia which used different methadone conversion methods. RESULTS:Methadone conversion ratios depended on previous opioid exposure and on the method of conversion used. The method most commonly used in Australia for calculating target doses for methadone when converting from strong opioids is a poor predictor of actual dose achieved. More appropriate conversion ratios are suggested. CONCLUSION:Further research is needed to refine the ratios used in practice when converting patients from strong opioids to methadone. Caution and clinical expertise are required. A palliative methadone registry may provide useful insights.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	BMJ PUBLISHING GROUP
dc.relation.ispartof	BMJ supportive & palliative care
dc.relation.isbasedon	10.1136/bmjspcare-2018-001645
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	1110 Nursing, 1117 Public Health and Health Services
dc.title	Conversion of other opioids to methadone: a retrospective comparison of two methods.
dc.type	Journal Article
utslib.citation.volume	10
utslib.location.activity	England
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-08-07T00:48:02Z
pubs.issue	2
pubs.publication-status	Published
pubs.volume	10
utslib.citation.issue	2

Abstract:

CONTEXT:A rapid method of methadone conversion known as the Perth Protocol is commonly used in Australian palliative care units. There has been no follow-up or validation of this method and no comparison between different methods of conversion. OBJECTIVES:The primary objective of this study was to test the hypothesis that the achieved doses of methadone are independent of the conversion method (rapid vs slower). The secondary objectives included examining the relationship between calculated target doses, actual achieved doses and duration of conversions. METHODS:This is a retrospective chart audit conducted at two hospital sites in the Brisbane metropolitan area of Australia which used different methadone conversion methods. RESULTS:Methadone conversion ratios depended on previous opioid exposure and on the method of conversion used. The method most commonly used in Australia for calculating target doses for methadone when converting from strong opioids is a poor predictor of actual dose achieved. More appropriate conversion ratios are suggested. CONCLUSION:Further research is needed to refine the ratios used in practice when converting patients from strong opioids to methadone. Caution and clinical expertise are required. A palliative methadone registry may provide useful insights.

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http://hdl.handle.net/10453/142005