Article Text
Abstract
Background and Importance We studied the physicochemical and microbiological stability of two methadone oral solutions 10 mg/mL. We demonstrated they were stable at 5 ± 3°C, 25 ± 2°C, and 40 ± 2°C for 91 days so that we increased the beyond-use-date (BUD) from 30 to 91 days.
Aim and Objectives Describe and analyse the impact after increasing the methadone solution BUD as well as the overall satisfaction in the-Methadone-Maintenance-Programme (MMP) Drug-Addicts-Attention-Centres (CAID) in our city, in which methadone compounding, distribution and dispensing is centralised in our Hospital-Pharmacy-Department.
Material and Methods One year after this implementation, a survey (8 questions) was designed with 6 possible Likert-scale answers (value 0 = ‘no-improvement’ and 5 = ‘very-significant-improvement’) asking if the BUD increase had allowed improvements in:
Day-to-day organisation.
Vacation organisation.
Human Resources (HR) distribution.
Dosing/dispensing methadone time reduction.
Other benefits not included in the survey.
Patient visits to the centre reduction (yes/no).
Other benefits in dispensing (yes/no).
Overall satisfaction (value 1 = ‘not-at-all-satisfied’ and 5 = ‘very-satisfied’).
The first 7 questions also included a free field to justify their score.
Results The response rate was 90% (18/20). Globally, the BUD increase has led an improvement in 61.1% CAID, highlighting better organisation, management and forecasting/internal planning (orders, shifts, vacations, doctor-nurse activities), as well as the possibility of dispensing more doses. During vacation/festive periods, 66.7% have noticed an improvement (being important/very-important in 38.9%), allowing better planning and dosing in advance. Regarding the HR distribution, the new BUD has not meant an improvement, or it has been of little importance in 94.6%. The reduction of dosing/dispensing time, has obtained a significant/very-significant improvement in 16.6%. In 22.2% CAID, it has allowed to reduce the number of visits to the centre. 27.8% found other important benefits for patients: adequacy of dispensing to their needs (travel, quarantine, vacations). 11.1% CAID indicated other benefits not included in the survey, highlighting the peace of mind due to the scientific certainty of the new BUD, as well as the possibility of ordering more methadone solution. The overall satisfaction was high: 55.6% very-satisfied/fairly-satisfied and the rest indifferent.
Conclusion and Relevance The increased stability of methadone oral solution has meant a high satisfaction degree in the MMP’s CAID, highlighting an improvement in the daily organisation and in festive periods; in relation to better planning/forecasting of shifts and internal activities; as well as a greater doses dispensing to patients whose clinical situation allowed it, reducing the number of visits to the centre.
Conflict of Interest No conflict of interest