Maddalena Opioid Switching Score in patients with cancer pain

Mercadante, Sebastiano; Cascio, Alessio Lo; Adile, Claudio; Ferrera, Patrizia; Casuccio, Alessandra

doi:10.1097/j.pain.0000000000002669

Cited by 6 publications

(6 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observed, as have others [9,10,12,13,18], that the opioid switch group represented a population of patients with difficult pain control. At the baseline, patients in the switch group experienced worse pain (background, breakthrough, and incident pain), more neuropathic pain (a higher S-LANNS score), a greater influence of pain on function (functional items from the BPI), adverse effects (items from ESAS), and psychological distress (one item from ECS-CP).…”

Section: Discussionsupporting

confidence: 82%

“…Studies have reported improvements in similar pain score outcomes post-switch. For example, recently, Mercadante et al [10] found a similar post-switch ESAS pain score reduction to 3.48 at a median of 6 days. Other studies using other scoring systems on a 0-10 scale (e.g., visual assessment scale, independent numerical rating scale) have also found pain outcomes of 3 or less at 3-14 days post-switch [3,13].…”

Section: Discussionmentioning

confidence: 83%

“…Observational data suggest opioid switching to be beneficial [5,6,9,10]; however, the rationale and mechanisms underlying the clinically different effects of various opioids in different people have not been well-studied, limiting support for this practice [3,9,[11][12][13][14]. Randomized trials comparing opioids such as morphine, oxycodone, hydromorphone, and methadone show no differences in efficacy or tolerability between these opioids; hence, one opioid should not necessarily be superior as the first-line opioid to another [6,[15][16][17].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study

Wong

Somogyi

Rubio

et al. 2023

Cancers

View full text Add to dashboard Cite

Opioid switching is a common practice of substituting one opioid for another to improve analgesia or adverse effects; however, it has limited evidence. This study aimed to examine the effectiveness of opioid switching in advanced cancer. This multi-center prospective cohort study recruited patients assessed to switch opioids (opioid switch group) or to continue ongoing opioid treatment (control group). Clinical data (demographics, opioids) and validated instruments (pain and adverse effects) were collected over two timepoints seven days apart. Descriptive analyses were utilized. Non-parametric tests were used to determine differences. Fifty-four participants were recruited (23 control group, 31 switch group). At the follow-up, opioid switching reduced pain (worst, average, and now) (p < 0.05), uncontrolled breakthrough pain (3-fold reduction, p = 0.008), and psychological distress (48% to 16%, p < 0.005). The switch group had a ≥25% reduction in the reported frequency of seven moderate-to-severe adverse effects (score ≥ 4), compared to a reduction in only one adverse effect in the control group. The control group experienced no significant pain differences at the follow-up. Opioid switching is effective at reducing pain, adverse effects, and psychological distress in a population with advanced cancer pain, to levels of satisfactory symptom control in most patients within 1 week.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study

Wong

Somogyi

Rubio

et al. 2023

Cancers

View full text Add to dashboard Cite

show abstract

“…Of interest, we reported data of complete successful OS in patients who were then discharged home, avoiding confounding terms such as partial success (21). In fact, patients who were reported to be successfully switched also reported a positive patient's global impression (11).…”

Section: Discussionmentioning

confidence: 99%

“…Ninety-ve patients who were admitted to an Acute Supportive/Palliative Care Unit (ASPCU) and had a successful OS were selected from a sample of a concomitant study assessing a tool for monitoring the outcomes of OS (11).from January 1, 2020, until June 30th 2021 (11).…”

Section: Methodsmentioning

confidence: 99%

Conversion ratios for opioid switching: a pragmatic study

Mercadante

Adile

Ferrera

et al. 2022

Support Care Cancer

Self Cite

View full text Add to dashboard Cite

Background: The nal conversion ratios among opioids used for successful switching are unknown. The aim of this study was to determine the initial and nal conversion ratios used for a successful opioid switching in cancer patients, and eventual associated factors.Methods: Ninety-ve patients who were successfully switched were evaluated. The following data were collected: age, gender, Karnofsky performance score, primary cancer, cognitive function, the presence of neuropathic, and incident pain. Opioids, route of administration, and their doses expressed in oral morphine equivalents used before OS, were recorded as well as opioids use for starting opioid switching, and at time of stabilization. Physical and psychological symptoms were routinely evaluated by Edmonton Symptom Assessment Scale.Results: No statistical changes were observed between the initial conversion ratios and those achieved at time of stabilization for all the sequences of opioid switching. When considering patients switched to methadone, there was no association between factors taken into considerations.Conclusion: Opioid switching is a highly effective and safe technique, improving analgesia and reducing the opioid-related symptom burden. The nal conversion ratios were not different from those used for starting opioid switching. Patients receiving higher doses of opioids should be carefully monitored for individual and unexpected responses in an experienced palliative care unit, particularly those switched to methadone. Future studies should provide data regarding the pro le of patients with di cult pain to be hospitalized.

show abstract

Switching to Intravenous Methadone in Advanced Cancer Patients: A Retrospective Analysis

Mercadante¹,

Cascio²,

Casuccio

2023

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

Maddalena Opioid Switching Score in patients with cancer pain

Abstract: An integrated score, taking into account pain and adverse effect intensity, provides simple data easy to compare in research studies of opioid switching for cancer pain.

Cited by 6 publications

References 31 publications

Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study

Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study

Conversion ratios for opioid switching: a pragmatic study

Switching to Intravenous Methadone in Advanced Cancer Patients: A Retrospective Analysis

Contact Info

Product

Resources

About