Monitoring electrocardiograms of service users on high-dose methadone substitution therapy: An audit

Abstract

Aims and method: To explore the extent to which 2007 Department of Health guidelines on monitoring of high-dose (≥100 mg) methadone were followed, the reasons for non-adherence to these and the prevalence of QTc prolongation. We developed a simple tool for collecting data from case notes. Results: Out of 25 service users, 11 had had an electrocardiogram (ECG) and 7 had evidence of requests sent to general practitioners. After implementation of our recommendations, ten more service users had ECGs within 1 month. All but one ECG was normal. Methadone prescribing in favour of lower doses has been observed. QTc interval prolongation was not common. Clinical implications: Effective communication between primary and secondary care services is important in identifying cases and arranging ECGs.