A Survey of the Status of Methadone Switching in Japan Using a Hospital-Based Administrative Claims Database

Shungo Imai, Natsumi Aoki, Keisuke Ikegami, Hayato Kizaki, Satoko Hori

研究成果: Article査読

抄録

Methadone is generally used for the management of cancer pain in patients who cannot obtain adequate analgesia from other strong opioids; however, it has a complicated and inconsistent conversion ratio from pre-switching opioid dosage to methadone. This issue may be pronounced in Japan because only oral tablets are commercially available. We aimed to elucidate the status of methadone switching in Japan, focusing on its dosage. Using a Japanese hospital-based administrative claims database, we included patients who switched to methadone between April 2008 and January 2021. The proportion of methadone switching completion that required more than the defined conversion ratio in the Japanese package insert (called “high-dose methadone switching”) was evaluated as a primary endpoint. Other endpoints included “the duration from initiation to completion of methadone switching” and “factors affecting high-dose methadone switching by using multivariate logistic regression analysis”. Of 1585 patients who received methadone, 370 were enrolled. Among those, 130 (35.1%) received high-dose methadone switching. The median duration of methadone switching completion (12 days) was longer in the high-dose methadone switching group than in other patients. Four variables were identified as factors affecting high-dose methadone switching. Younger age and outpatient status increased the risk of requiring high-dose methadone switching, whereas the concomitant use of nonsteroidal anti-inflammatory drugs and fentanyl as a pre-switching opioid decreased the risk. In conclusion, more than 30% of the patients underwent high-dose methadone switching and required long completion periods, suggesting that methadone switching remains challenging in Japan.

本文言語English
ページ(範囲)189-195
ページ数7
ジャーナルJournal of Clinical Pharmacology
64
2
DOI
出版ステータスPublished - 2024 2月

ASJC Scopus subject areas

  • 薬理学
  • 薬理学(医学)

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