Intrathecal Drug Delivery Systems Survey: Trends in Utilization in Pain Practice
Alaa Abd-Sayed,1 Kenneth Fiala,1 Jacqueline Weibstein,2 Pooja Chopra,3 Christopher Lam,4 Hemant Kalia,5 Navdeep Jassal,6 Amitabh Gulati,7 Dawood Sayed,4 Timothy Deer8 1Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792-3272, USA; 2Napa Vall...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2022-05-01
|
| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/intrathecal-drug-delivery-systems-survey-trends-in-utilization-in-pain-peer-reviewed-fulltext-article-JPR |
| _version_ | 1828783533180583936 |
|---|---|
| author | Abd-Sayed A Fiala K Weibstein J Chopra P Lam C Kalia H Jassal N Gulati A Sayed D Deer T |
| author_facet | Abd-Sayed A Fiala K Weibstein J Chopra P Lam C Kalia H Jassal N Gulati A Sayed D Deer T |
| author_sort | Abd-Sayed A |
| collection | DOAJ |
| description | Alaa Abd-Sayed,1 Kenneth Fiala,1 Jacqueline Weibstein,2 Pooja Chopra,3 Christopher Lam,4 Hemant Kalia,5 Navdeep Jassal,6 Amitabh Gulati,7 Dawood Sayed,4 Timothy Deer8 1Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792-3272, USA; 2Napa Valley Orthopedic Medical Group, Napa, CA, 94558, USA; 3Bux Pain Management, Danville, KY, 40422, USA; 4Department of Anesthesiology, University of Kansas, Kansas City, KS, 66160, USA; 5Rochester Regional Health, Rochester, NY, 14626, USA; 6Excel Pain and Spine, Lakeland, FL, 33805, USA; 7Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, NY, NY, 10604, USA; 8Department of Anesthesiology, University of West Virginia, Charleston, WV, 25301, USACorrespondence: Alaa Abd-Sayed, Email alaaawny@hotmail.comBackground: The use of intrathecal drug delivery for chronic and cancer pain medicine has been established for decades. However, optimization and utilization of this technique still lag behind other modalities for pain control. Some of this may be due to variability of surgical technique, medication usage and education. It is currently unclear on whether or not practitioners follow available algorithms for the use of intrathecal drug delivery systems.Methods: A survey developed by the American Society of Pain and Neuroscience (ASPN) was sent to its members via email using the cloud-based SurveyMonkey. After 30 days of being available, 159 different providers responded to the survey that consisted of 31 various multiple choice and free response questions. Each question was not required and the number of responses to each varied from 128 to 159.Results: Approximately 9% of those who successfully received and opened the email containing the survey responded, likely due to a small number of providers working with intrathecal drug delivery systems. Eighty-six of respondents practice medicine in the United States, and 87% of the respondents were attending physicians. A majority of respondents, approximately 74%, were board certified in pain medicine with 69% of respondents being train in anesthesiology. The first and second most used medications for intrathecal pump trial were morphine and fentanyl, respectively. Most respondents, approximately 96%, provide pre-operative/intra-operative antibiotics. The most common first-choice medication for implanted intrathecal pumps was also morphine with the most common implanted location being the abdomen.Conclusion: Interestingly, there is currently fairly substantial variation in the way providers utilize intrathecal pump delivery for both chronic and cancer pain. There is variation from the training background of the providers providing care, to the pre-implantation trial medications, to where the pump is implanted for each patient, to if the patient has the option to give themselves boluses once implanted. Further research is needed to elucidate current and best practices for intrathecal drug delivery system trials, implantations, and utilization.Keywords: pain management, intrathecal, chronic pain, cancer pain, neuromodulation, analgesia |
| first_indexed | 2024-12-11T23:14:42Z |
| format | Article |
| id | doaj.art-289f8883cb5a43c485aae4600ddda3f5 |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-11T23:14:42Z |
| publishDate | 2022-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-289f8883cb5a43c485aae4600ddda3f52022-12-22T00:46:35ZengDove Medical PressJournal of Pain Research1178-70902022-05-01Volume 151305131475002Intrathecal Drug Delivery Systems Survey: Trends in Utilization in Pain PracticeAbd-Sayed AFiala KWeibstein JChopra PLam CKalia HJassal NGulati ASayed DDeer TAlaa Abd-Sayed,1 Kenneth Fiala,1 Jacqueline Weibstein,2 Pooja Chopra,3 Christopher Lam,4 Hemant Kalia,5 Navdeep Jassal,6 Amitabh Gulati,7 Dawood Sayed,4 Timothy Deer8 1Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792-3272, USA; 2Napa Valley Orthopedic Medical Group, Napa, CA, 94558, USA; 3Bux Pain Management, Danville, KY, 40422, USA; 4Department of Anesthesiology, University of Kansas, Kansas City, KS, 66160, USA; 5Rochester Regional Health, Rochester, NY, 14626, USA; 6Excel Pain and Spine, Lakeland, FL, 33805, USA; 7Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, NY, NY, 10604, USA; 8Department of Anesthesiology, University of West Virginia, Charleston, WV, 25301, USACorrespondence: Alaa Abd-Sayed, Email alaaawny@hotmail.comBackground: The use of intrathecal drug delivery for chronic and cancer pain medicine has been established for decades. However, optimization and utilization of this technique still lag behind other modalities for pain control. Some of this may be due to variability of surgical technique, medication usage and education. It is currently unclear on whether or not practitioners follow available algorithms for the use of intrathecal drug delivery systems.Methods: A survey developed by the American Society of Pain and Neuroscience (ASPN) was sent to its members via email using the cloud-based SurveyMonkey. After 30 days of being available, 159 different providers responded to the survey that consisted of 31 various multiple choice and free response questions. Each question was not required and the number of responses to each varied from 128 to 159.Results: Approximately 9% of those who successfully received and opened the email containing the survey responded, likely due to a small number of providers working with intrathecal drug delivery systems. Eighty-six of respondents practice medicine in the United States, and 87% of the respondents were attending physicians. A majority of respondents, approximately 74%, were board certified in pain medicine with 69% of respondents being train in anesthesiology. The first and second most used medications for intrathecal pump trial were morphine and fentanyl, respectively. Most respondents, approximately 96%, provide pre-operative/intra-operative antibiotics. The most common first-choice medication for implanted intrathecal pumps was also morphine with the most common implanted location being the abdomen.Conclusion: Interestingly, there is currently fairly substantial variation in the way providers utilize intrathecal pump delivery for both chronic and cancer pain. There is variation from the training background of the providers providing care, to the pre-implantation trial medications, to where the pump is implanted for each patient, to if the patient has the option to give themselves boluses once implanted. Further research is needed to elucidate current and best practices for intrathecal drug delivery system trials, implantations, and utilization.Keywords: pain management, intrathecal, chronic pain, cancer pain, neuromodulation, analgesiahttps://www.dovepress.com/intrathecal-drug-delivery-systems-survey-trends-in-utilization-in-pain-peer-reviewed-fulltext-article-JPRpain managementintrathecalchronic paincancer painneuromodulationanalgesia |
| spellingShingle | Abd-Sayed A Fiala K Weibstein J Chopra P Lam C Kalia H Jassal N Gulati A Sayed D Deer T Intrathecal Drug Delivery Systems Survey: Trends in Utilization in Pain Practice Journal of Pain Research pain management intrathecal chronic pain cancer pain neuromodulation analgesia |
| title | Intrathecal Drug Delivery Systems Survey: Trends in Utilization in Pain Practice |
| title_full | Intrathecal Drug Delivery Systems Survey: Trends in Utilization in Pain Practice |
| title_fullStr | Intrathecal Drug Delivery Systems Survey: Trends in Utilization in Pain Practice |
| title_full_unstemmed | Intrathecal Drug Delivery Systems Survey: Trends in Utilization in Pain Practice |
| title_short | Intrathecal Drug Delivery Systems Survey: Trends in Utilization in Pain Practice |
| title_sort | intrathecal drug delivery systems survey trends in utilization in pain practice |
| topic | pain management intrathecal chronic pain cancer pain neuromodulation analgesia |
| url | https://www.dovepress.com/intrathecal-drug-delivery-systems-survey-trends-in-utilization-in-pain-peer-reviewed-fulltext-article-JPR |
| work_keys_str_mv | AT abdsayeda intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT fialak intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT weibsteinj intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT choprap intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT lamc intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT kaliah intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT jassaln intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT gulatia intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT sayedd intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice AT deert intrathecaldrugdeliverysystemssurveytrendsinutilizationinpainpractice |