External validation of the medication taper complexity score for methadone tapers in children with opioid abstinence syndrome

Ann Pharmacother. 2014 Feb;48(2):187-95. doi: 10.1177/1060028013512110. Epub 2013 Nov 12.

Abstract

Background: Methadone is commonly prescribed for children with opioid abstinence syndrome (OAS) as a taper schedule over several days to weeks. The Medication Taper Complexity Score (MTCS) was developed to evaluate outpatient methadone tapers.

Objective: To further validate the MTCS and determine if it is a reliable tool for clinicians to use to assess the complexity of methadone tapers for OAS.

Methods: An expert panel of pediatric clinical pharmacists was convened. Panel members were provided 9 methadone tapers (ie, "easy," "medium," and "difficult") to determine construct and face validity of the MTCS. The primary objective was to further establish reliability and construct/face validity of the MTCS. The secondary objective was to assess the reliability of the MTCS within and between tapers. Instrument reliability was assessed using a Pearson correlation coefficient; with 0.8 as the minimum acceptable coefficient. Construct (divergent) validity was assessed via a repeated-measures ANOVA analysis (Bonferroni post hoc analyses) of the mean scores provided by panel members.

Results: Six panel members were recruited from various geographical locations. Panel members had 18.3 ± 5.5 years of experience, with practice expertise in general pediatrics, hematology/oncology, and the pediatric and neonatal intensive care unit. The MTCS had a reliability coefficient of .9949. There was vivid discrimination between the easy, medium, and difficult tapers; P = .001. The panel recommended minor modifications to the MTCS.

Conclusions: The MTCS was found to be a reliable and valid tool. Overall, the panel felt that the MTCS was easy to use and had potential applications in both practice and research.

Keywords: children; methadone; opioid withdrawal.

Publication types

  • Validation Study

MeSH terms

  • Analgesics, Opioid / administration & dosage*
  • Child
  • Drug Administration Schedule
  • Humans
  • Methadone / administration & dosage*
  • Neonatal Abstinence Syndrome / drug therapy*
  • Opiate Substitution Treatment
  • Opioid-Related Disorders / drug therapy*
  • Reproducibility of Results

Substances

  • Analgesics, Opioid
  • Methadone