Maddalena Opioid Switching Score (MOSS) in patients with cancer pain

Evaluation of opioid switching (OS) for cancer pain has not been properly assessed. The aim of this study was to assess an integrated score (Maddalena Opioid Switching Score, MOSS) as a simple and repeatable tool to evaluate the outcomes of OS, facilitating the interpretation and comparison of studies, and information exchange among researchers. The integrated score took into account pain intensity, intensity of opioid-related symptoms, and cognitive function by using an authors' formula. Physical and psychological symptoms were evaluated by Edmonton Symptom Assessment Scale (ESAS) and patient global impression (PGI) by the minimal clinically important difference (MCID).One-hundred-six patients were analyzed. Ninety-five patients were switched successfully, and eleven patients underwent a further OS and/or alternative procedure. MOSS significantly decreased after OS and was highly correlated to PGI of improvement (P<0.0005). In patients with unsuccessful OS, no significant changes in MOSS and PGI were observed. A significant reduction in ESAS items intensity was observed after OS.MOSS resulted to be a sensitive instrument for measuring the clinical improvement produced by OS.