{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:29:22Z","timestamp":1791430162506,"version":"4.3.3"},"reference-count":21,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T00:00:00Z","timestamp":1362096000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2013,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Previous research has reported improved pain after adding methadone to another opioid, but did not quantify this benefit using a validated outcome measure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess quantitatively the effectiveness of adding methadone to another opioid for moderate to severe cancer-related pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>All outpatients attending the Oncology Palliative Care Clinic from September 2010\u2013September 2011, who had received methadone, were identified from pharmacy records. Inclusion criteria included: histological diagnosis of malignancy, age &gt;18 years, taking regular opioids and Edmonton Symptom Assessment System (ESAS) pain score \u22654.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurement:<\/jats:title>\n                    <jats:p>The primary outcome measure was a decrease in pain score of \u22652 points from methadone initiation to one-month follow-up (or closest available ESAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty patients were available for analysis, 16 of whom had neuropathic pain (80%). Eight patients (40%) had a decrease in pain score of \u22652 points at 1 month and a further 7 (35%) had a decrease of \u22652 points at the closest available time point. The mean pain score decreased from 7.7\u2009+\/\u2212\u20091.8 to 5.2\u2009+\/\u2212\u20092.4 from time of initiation to time of evaluation. The mean daily routine morphine equivalent, (excluding methadone), was 338\u2009+\/\u2212\u2009217.8\u2009mg\/day at initiation and 332\u2009+\/\u2212\u2009191\u2009mg\/day at evaluation; for methadone, mean doses at initiation and evaluation were 4.4\u2009+\/\u2212\u20091.4\u2009mg\/day and 15.5\u2009+\/\u2212\u20095.9\u2009mg\/day, respectively. Methadone was well tolerated in 17 patients (85%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The addition of methadone was associated with improved pain control for patients with moderate to severe pain on another opioid and appears to offer a safe, well-tolerated and practical alternative in this situation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jpm.2012.0335","type":"journal-article","created":{"date-parts":[[2013,2,7]],"date-time":"2013-02-07T09:56:52Z","timestamp":1360231012000},"page":"305-309","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Addition of Methadone to Another Opioid in the Management of Moderate to Severe Cancer Pain: A Case Series"],"prefix":"10.1177","volume":"16","author":[{"given":"Elaine","family":"Wallace","sequence":"first","affiliation":[{"name":"University Health Network","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Ridley","sequence":"additional","affiliation":[{"name":"University Health Network","place":["Canada"]},{"name":"University of Toronto","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Bryson","sequence":"additional","affiliation":[{"name":"University Health Network","place":["Canada"]},{"name":"University of Toronto","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernie","family":"Mak","sequence":"additional","affiliation":[{"name":"University Health Network","place":["Canada"]},{"name":"University of Toronto","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"University Health Network","place":["Canada"]},{"name":"University of Toronto","place":["Canada"]},{"name":"University of Toronto","place":["Canada"]},{"name":"University Health Network","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,3,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216310392101"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(97)00093-6"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-6147(00)01616-3"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2004.06.006"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00230-4"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2008.00501.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2011.06.005"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2011.12.270"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/082585979901500304"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-005-0834-3"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(20000501)88:9<2164::AID-CNCR24>3.0.CO;2-5"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.03.090"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm121"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.4065\/77.4.371"},{"issue":"5","key":"e_1_3_2_16_2","first-page":"695","article-title":"An alternative algorithm for dosing transdermal fentanyl for cancer-related pain","volume":"14","author":"Breitbart W","year":"2000","unstructured":"Breitbart W, , Chandler S, , Eagel B, , Ellison N, , Enck RE, , Lefkowitz M et al. 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