The opiate dosage adequacy scale for identification of the right methadone dose--a prospective cohort study
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The opiate dosage adequacy scale for identification of the right methadone dose--a prospective cohort study. / Walcher, Stephan; Koc, John; Reichel, Volker; Schlote, Frank; Verthein, Uwe; Reimer, Jens.
In: BMC PHARMACOL TOXICO, Vol. 17, 07.04.2016, p. 15.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The opiate dosage adequacy scale for identification of the right methadone dose--a prospective cohort study
AU - Walcher, Stephan
AU - Koc, John
AU - Reichel, Volker
AU - Schlote, Frank
AU - Verthein, Uwe
AU - Reimer, Jens
PY - 2016/4/7
Y1 - 2016/4/7
N2 - BACKGROUND: Opioid maintenance treatment with methadone is regarded as gold standard in the therapy of opioid dependence. Identification of the 'right' methadone dose, however, remains challenging. We wanted to explore if the Opiate Dosage Adequacy Scale (ODAS) is a helpful instrument in methadone titration.METHODS: Within this 12-months prospective naturalistic cohort study patients in stable maintenance treatment with methadone (Eptadone®) were included. Sociodemographic and clinical data were gathered at baseline, and months 3, 6, and 12. At the same points in time, the instruments ODAS, European Addiction Severity Index (EuropASI), and Derogatis Interview for Sexual Functioning-Self Report (DISF-SR) were applied.RESULTS: Five hundred fifteen patients were enrolled, 129 patients prematurely terminated substitution treatment (treatment failure), in 108 patients substitution medication was changed, likely due to bitter taste of Eptadone®. Complete longitudinal ODAS and EuropASI data sets were available for 229 patients. The frequency of adequate methadone doses (ODAS) increased (60.9 % at baseline, 85.3 % at month 12) as well as the average daily methadone dose (63.8 (±30.8) mg/day at baseline to 69.6 (±36.0) mg/day at month 12). Inadequacy of methadone dose was not associated with treatment failure (RR 1.019; CI 95 % 0.756-1.374). Addiction severity decreased statistically significantly. Compared to adequately dosed patients, inadequately dosed patients benefited more, in that they showed greater improvements in ODAS scores, had higher increases in methadone dose, and partially experienced more advanced sexual functioning.CONCLUSION: Application of ODAS was associated with improved methadone dose adequacy and addiction severity parameters as well as increased methadone doses. Its usefulness should be corroborated in a controlled trial.
AB - BACKGROUND: Opioid maintenance treatment with methadone is regarded as gold standard in the therapy of opioid dependence. Identification of the 'right' methadone dose, however, remains challenging. We wanted to explore if the Opiate Dosage Adequacy Scale (ODAS) is a helpful instrument in methadone titration.METHODS: Within this 12-months prospective naturalistic cohort study patients in stable maintenance treatment with methadone (Eptadone®) were included. Sociodemographic and clinical data were gathered at baseline, and months 3, 6, and 12. At the same points in time, the instruments ODAS, European Addiction Severity Index (EuropASI), and Derogatis Interview for Sexual Functioning-Self Report (DISF-SR) were applied.RESULTS: Five hundred fifteen patients were enrolled, 129 patients prematurely terminated substitution treatment (treatment failure), in 108 patients substitution medication was changed, likely due to bitter taste of Eptadone®. Complete longitudinal ODAS and EuropASI data sets were available for 229 patients. The frequency of adequate methadone doses (ODAS) increased (60.9 % at baseline, 85.3 % at month 12) as well as the average daily methadone dose (63.8 (±30.8) mg/day at baseline to 69.6 (±36.0) mg/day at month 12). Inadequacy of methadone dose was not associated with treatment failure (RR 1.019; CI 95 % 0.756-1.374). Addiction severity decreased statistically significantly. Compared to adequately dosed patients, inadequately dosed patients benefited more, in that they showed greater improvements in ODAS scores, had higher increases in methadone dose, and partially experienced more advanced sexual functioning.CONCLUSION: Application of ODAS was associated with improved methadone dose adequacy and addiction severity parameters as well as increased methadone doses. Its usefulness should be corroborated in a controlled trial.
KW - Adult
KW - Ambulatory Care Facilities
KW - Analgesics, Opioid
KW - Cohort Studies
KW - Drug Monitoring
KW - Female
KW - Germany
KW - Heroin Dependence
KW - Humans
KW - Longitudinal Studies
KW - Maintenance Chemotherapy
KW - Male
KW - Methadone
KW - Middle Aged
KW - Opiate Substitution Treatment
KW - Patient Compliance
KW - Patient Dropouts
KW - Prospective Studies
KW - Psychiatric Status Rating Scales
KW - Severity of Illness Index
KW - Sexual Dysfunction, Physiological
KW - Journal Article
KW - Multicenter Study
KW - Observational Study
KW - Research Support, Non-U.S. Gov't
U2 - 10.1186/s40360-016-0058-9
DO - 10.1186/s40360-016-0058-9
M3 - SCORING: Journal article
C2 - 27052201
VL - 17
SP - 15
JO - BMC PHARMACOL TOXICO
JF - BMC PHARMACOL TOXICO
SN - 2050-6511
ER -
