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Safe and Appropriate Use of Methadone in Hospice and Palliative Care: Expert Consensus White Paper.

MedStar author(s):

Citation: Journal of Pain & Symptom Management. 57(3):635-645.e4, 2019 03.PMID: 30578934Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Analgesics, Opioid/tu [Therapeutic Use] | *Hospice Care | *Methadone/tu [Therapeutic Use] | *Pain/dt [Drug Therapy] | *Palliative Care | Analgesics, Opioid/ae [Adverse Effects] | Humans | Methadone/ae [Adverse Effects]Year: 2019 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:

0885-3924

Name of journal: Journal of pain and symptom managementAbstract: Copyright (c) 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.Methadone has several unique characteristics that make it an attractive option for pain relief in serious illness, but the safety of methadone has been called into question after reports of a disproportionate increase in opioid-induced deaths in recent years. The American Pain Society (APS), College on Problems of Drug Dependence, and the Heart Rhythm Society collaborated to issue guidelines on best practices to maximize methadone safety and efficacy, but guidelines for the end-of-life scenario have not yet been developed. A panel of 15 interprofessional hospice and palliative care experts from the US and Canada convened in February 2015 to evaluate the APS methadone recommendations for applicability in the hospice and palliative care setting. The goal was to develop guidelines for safe and effective management of methadone therapy in hospice and palliative care. This article represents the consensus opinion of the hospice and palliative care experts for methadone use at end of life, including guidance on appropriate candidates for methadone, detail in dosing, titration, and monitoring of patients' response to methadone therapy.All authors: Bemben NM, Bruera E, Chou R, Davis MP, Lapointe BJ, Lockman DK, Malotte K, McPherson ML, Paice J, Ray JB, Reddy A, Salpeter S, Walker KA, Wellman COriginally published: Journal of Pain & Symptom Management. 2018 Dec 19Fiscal year: FY2019Digital Object Identifier:

https://dx.doi.org/10.1016/j.jpainsymman.2018.12.001

Date added to catalog: 2019-01-08

Holdings ( 1 )
Title notes ( 4 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	30578934	Available		30578934

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

Methadone has several unique characteristics that make it an attractive option for pain relief in serious illness, but the safety of methadone has been called into question after reports of a disproportionate increase in opioid-induced deaths in recent years. The American Pain Society (APS), College on Problems of Drug Dependence, and the Heart Rhythm Society collaborated to issue guidelines on best practices to maximize methadone safety and efficacy, but guidelines for the end-of-life scenario have not yet been developed. A panel of 15 interprofessional hospice and palliative care experts from the US and Canada convened in February 2015 to evaluate the APS methadone recommendations for applicability in the hospice and palliative care setting. The goal was to develop guidelines for safe and effective management of methadone therapy in hospice and palliative care. This article represents the consensus opinion of the hospice and palliative care experts for methadone use at end of life, including guidance on appropriate candidates for methadone, detail in dosing, titration, and monitoring of patients' response to methadone therapy.

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