Clinicians' Perspectives on Low-Dose Methadone for Chronic Pain in Nursing Homes: A Post-Lecture Survey

A cross-sectional post-lecture survey was conducted among healthcare professionals attending an educational session on low-dose methadone (LDM). This study assessed participants' familiarity with and attitudes toward LDM, perceived barriers to use, and implications for future educational and implementation strategies to support safe and appropriate adoption of LDM in nursing homes (NHs). Eighty-nine attendees completed the survey. A majority of respondents reported working in long-term care (78.7%), post- acute care (61.8%), and assisted living facilities (42.7%). Approximately 42% had 20 or more years of experience. Forty-six percent reported limited experience with LDM. Only 12% reported being very familiar with regular utilization. Commonly cited concerns included lack of familiarity (57.3%) and difficulty with dosing and titration (55.1%). Additional concerns included regulatory barriers (32.6%) and risk of QTc prolongation (30.3%). After hearing the session, participants agreed with advantages of LDM including its utility in various types of pain (89.9%), safety in renal impairment (82%), ability to administer to patients with dysphagia (71.9%), and ability to provide long- acting analgesia (70.8%). Ninety-two percent of respondents reported being more likely to consider using LDM. Addressing remaining barriers through educational interventions, guidelines updates, standardized protocols, and more studies examining the use of LDM will help promote its use.