The need for pain treatment based on opioid analgesics increases, but their use is often limited by side effects, including cognitive disorders. It is important to evaluate cognitive status during opioid treatment. A retrospective review of methadone prescriptions over 17 months in a university hospital database was followed by a medical records review of 74 patients, of which 73% were aged 60 years or older, 74% had chronic clinical conditions, and 64% had been admitted for pain. The mean initial pain intensity was 4.8/10 (SD: 3.3), while the mean intensity after treatment was 1.8/10 (SD: 2.0). The most frequent type of pain was oncologic (49%), and prescriptions were generated by specialists affiliated to pain services (75%). A quarter of patients treated with methadone experienced cognitive disorders; this was more common in men, patients aged 60 years and older, and those exposed to benzodiazepines and higher doses of methadone. Optimal use of nonsteroidal anti-inflammatory drugs and other analgesics is essential to decrease the opioid dose and limit the use of benzodiazepines. Patients undergoing methadone therapy should be assessed for cognitive function before starting treatment and at the end of treatment. (DOLOR. 2016;31:29-36).
|Publication status||Published - 1 Jan 2016|