MAT Titration Order

Creating a MAT titration order allows you to create a MAT order with an increasing dose. 

Follow the steps below to create a titration order:

1. Click on Queues in the header.
2. Check the Patient into the Dosing Queue.
    

3. Click on the New Order button.

   Note: If the patient has an existing order, you can discontinue the order and create a new one, or create a Change Order. 

4. Select a MAT order template from the drop-down menu (optional).
5. Once you select a template, the system will autofill the remaining fields based on the template configuration. Click here to learn more about MAT order templates.
6. Select a phase for the patient. Phases are only informational on the order and don't impact dosing.
7. Choose the medication being ordered. The Route, Dosage Form, and Strength fields will autofill based on this selection.
   Note: Medications are configured in your MAT location settings. 
8. Check Blind, if needed to hide the medication dose from the patient when capturing their dosing signature. This is helpful when tapering off the patient's medication. This box is typically used when creating a taper order.
9. Select Titration from the Order Type drop-down to create an increasing dose.
10. Select the order's start date from the Start Date field. You can type in the date or choose it from the calendar. The default is the current date.
11. You can specify an end date for this order or leave it blank. On the day after this date, the order will automatically discontinue and no medication can be dispensed. 
12. Next, set up the patient's on-site schedule.
    1. Daily: Update the week drop-down to Day. This option requires the patient to be onsite each day.
       
    2. Weekly: Set the number of weeks the patient must come in (e.g., 1 = each week, 2 = every two weeks). Then, choose the days of the week the patient will come into the facility to be dosed.
       
13. Select Fixed or Custom.

    • Fixed: Allows dose adjustments that follow a consistent pattern, increasing the dose by the same amount, at the same frequency.

      1. Enter the starting dose amount in the Dose field.
      2. Enter the amount the dose should increase by in the Change By field.
      3. Choose the appropriate dosage measurement based on the medication. Liquid methadone supports either a mg or % increase. Non-liquid medications only support a mg increase.
      4. In the Change Every field, enter the number of days between dose changes. For example, if you wanted the dose to increase every two days, enter a 2.
      5. Enter the final dose amount in the Until Dose Reaches field. This number must be higher than the starting dose amount. The order will increase the amount based on the frequency chosen until this dose is reached. Once this dose is reached, the patient will continue to be dosed at this final dose until the order is discontinued or changed.
    • Custom: Allow manual building of the titration order on a per-day basis.
               
      1. Click Add Split+ if needed.
         
      2. You can split the patient's dose and administer it two or more times during the same day. Common reasons for using split dosing include patients who are rapid metabolizers of the medication, pregnant patients, or patients taking other medications that interfere with this medication.
         
      3. Click +Add Day button to add a consecutive day.
         
      4. Complete the dosing details for each day, repeating the steps as needed until the custom titration order is finalized.
         • Note: The end date is automatically calculated based on the total number of days in the order and cannot be edited manually.
           
14. Use Take Outs to dispense all doses at once as take-home doses, overriding the on-site dosing schedule.
     
15. Enter notes as needed.
16. The phase requirements appear at the end of the order.
17. Doctor users can click Submit to create the order. Other users will need to select the ordering physician from the Ordered By drop-down and the ordering method from the Ordered Via drop-down.
18. Dose Alert: You may receive a Dose Alert when submitting the titration order. The system will compare the last dose of the previous order to the starting dose of the new order and will alert you if the medication ordered equals or exceeds the Dose Out of Range setting for the medication. You can click Continue to proceed with the order creation or Cancel to review and adjust the order as needed.
    
19. The order is set as the patient's Current/Active Order.
20. Alternatively, you can use the MAT Order tab to complete this workflow.