{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T23:58:01Z","timestamp":1793404681757,"version":"4.5.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"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":[[2026,4,1]]},"abstract":"\n Background:<\/jats:title>\n Adjunct methadone has been used previously for cancer-related pain, but evidence on predictors for early response remains limited.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n Identify the prevalence and predictors of early adjunct methadone response in palliative care patients.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Settings\/Subjects:<\/jats:title>\n Patients who initiated adjunct methadone from 2022 to 2024.<\/jats:p>\n <\/jats:sec>\n \n Measurement:<\/jats:title>\n Univariate and multivariate Poisson regression identified prevalence and predictors of early response.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 42 patients, 28 (67%) achieved early response. They had higher baseline oral morphine equivalents, higher starting methadone doses, and shorter days to first titration (\n p<\/jats:italic>\n < 0.05). Predictors included metastatic cancer (RR 3.30,\n p<\/jats:italic>\n = 0.005), higher performance status (RR 2.58,\n p<\/jats:italic>\n = 0.033), methadone daily dose >5 mg (RR 3.91,\n p<\/jats:italic>\n = 0.013), lower baseline pain scores (RR 0.78,\n p<\/jats:italic>\n = 0.025), and preserved liver function (RR 4.32,\n p<\/jats:italic>\n = 0.009).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Metastatic cancer patients with high performance status without liver damage may benefit from a higher, proactively titrated starting dose of adjunct methadone.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10966218251392363","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:29:26Z","timestamp":1761823766000},"page":"503-507","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Predictors of Early Response to Adjunct Methadone for Cancer-Related Pain in Palliative Care Patients\u2014A Retrospective Study"],"prefix":"10.1177","volume":"29","author":[{"given":"Kenny Kwon Ho","family":"Lee","sequence":"first","affiliation":[{"name":"Sydney School of Pharmacy, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia."},{"name":"Department of Pharmacy Services, Chris O\u2019Brien Lifehouse Hospital, Camperdown, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Johns","sequence":"additional","affiliation":[{"name":"Department of Acute Pain Medicine, Chris O\u2019Brien Lifehouse Hospital, Camperdown, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Technology Sydney, Ultimo, Australia."},{"name":"St. Vincent Health Australia, Sydney, Australia."},{"name":"HammondCare, Royal North Shore Hospital, St. Leonards, Australia."},{"name":"Northern Clinical School, University of Sydney, St. Leonards, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Penm","sequence":"additional","affiliation":[{"name":"Sydney School of Pharmacy, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia."},{"name":"Department of Pharmacy, Prince of Wales Hospital, Randwick, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Australian Institute of Health and Welfare. 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