{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:59:59Z","timestamp":1756461599356,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["accp1.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Clinical Pharma"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>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\u2010switching 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\u2010based 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 \u201chigh\u2010dose methadone switching\u201d) was evaluated as a primary endpoint. Other endpoints included \u201cthe duration from initiation to completion of methadone switching\u201d and \u201cfactors affecting high\u2010dose methadone switching by using multivariate logistic regression analysis\u201d. Of 1585 patients who received methadone, 370 were enrolled. Among those, 130 (35.1%) received high\u2010dose methadone switching. The median duration of methadone switching completion (12 days) was longer in the high\u2010dose methadone switching group than in other patients. Four variables were identified as factors affecting high\u2010dose methadone switching. Younger age and outpatient status increased the risk of requiring high\u2010dose methadone switching, whereas the concomitant use of nonsteroidal anti\u2010inflammatory drugs and fentanyl as a pre\u2010switching opioid decreased the risk. In conclusion, more than 30% of the patients underwent high\u2010dose methadone switching and required long completion periods, suggesting that methadone switching remains challenging in Japan.<\/jats:p>","DOI":"10.1002\/jcph.2351","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T10:58:50Z","timestamp":1695380330000},"page":"189-195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Survey of the Status of Methadone Switching in Japan Using a Hospital\u2010Based Administrative Claims Database"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5706-613X","authenticated-orcid":false,"given":"Shungo","family":"Imai","sequence":"first","affiliation":[{"name":"Division of Drug Informatics Keio University Faculty of Pharmacy  Minato\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsumi","family":"Aoki","sequence":"additional","affiliation":[{"name":"Division of Drug Informatics Keio University Faculty of Pharmacy  Minato\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6942-590X","authenticated-orcid":false,"given":"Keisuke","family":"Ikegami","sequence":"additional","affiliation":[{"name":"Division of Drug Informatics Keio University Faculty of Pharmacy  Minato\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayato","family":"Kizaki","sequence":"additional","affiliation":[{"name":"Division of Drug Informatics Keio University Faculty of Pharmacy  Minato\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4596-5418","authenticated-orcid":false,"given":"Satoko","family":"Hori","sequence":"additional","affiliation":[{"name":"Division of Drug Informatics Keio University Faculty of Pharmacy  Minato\u2010ku Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Pharmaceuticals and Medical Devices Agency.METHAPAIN tablets.2002. 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