title: External validation of the medication taper complexity score for methadone tapers in children with opioid abstinence syndrome.
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.
authors.affiliation: University of Oklahoma College of Pharmacy, Oklahoma City, OK, USA.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Johnson
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Miller
authors.forename: Tracy M
authors.initials: TM
authors.lastname: Hagemann
authors.forename: Christine
authors.initials: C
authors.lastname: Castro
authors.forename: Donald
authors.initials: D
authors.lastname: Harrison
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002648:Child; D004334:Drug Administration Schedule; D006801:Humans; D008691:Methadone / Q000008:administration & dosage*; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D015203:Reproducibility of Results
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: children; methadone; opioid withdrawal