Beatson drug delivery study shows patient benefits
A new service evaluation on the use of intrathecal drug delivery (ITDD) by the Interventional Cancer Pain team at the Beatson West of Scotland Cancer Centre has shown patients having a better quality of life by being able to spend more time being cared for in the community.
As well as this, the pump devices mean patients are on a lower dose of opioid painkillers, which reduces cognitive impairment.
Dr Alison Mitchell led the work which has been published in the journal Palliative Medicine.
The ITDD service offered by the Beatson WoSCC is the only one in Scotland and it is hoped the findings of this study will support the use of ITDD further afield.
Dr Mitchell, Consultant in Palliative Medicine, said: “We have been using ITDD since 2007 and this research confirms the benefits that it has for patients who have significant pain due to a variety of cancers.
“It’s an appropriate method of pain relief for a small percentage of patients and makes a real difference to their quality of life.”
The devices use an implanted catheter in the lumbar area of the spine which allows delivery of anaesthetic and painkilling medication from a pump which sits just below the ribcage.
After the device is implanted, patients return every two weeks to have the medication reservoir refilled.
Dr Mitchell explained: “As the medication is delivered directly to the spinal cord, the local anaesthetic administered by the device acts like a dental anaesthetic by numbing pain nerves directly and we try to ensure it does not impair motor function in the way a dental anaesthetic would affect your face muscles.
“The morphine delivered by the pumps relieves the pain associated with cancers and means patients can reduce their oral morphine use and patients with pumps are on a much lower overall morphine dosage.
“This means they are better able to spend quality time with their families as they don’t experience the cognitive impairment that morphine usage can cause.”
Patients requiring pain relief in the lower half of the body are assessed by a multidisciplinary team made up of palliative medicine, physiotherapy and psychiatric specialists and a decision can be made on how appropriate this method of pain relief would be for them.
Dr Mitchell added: “The team takes a holistic approach to how we help people manage pain in a palliative setting.
“Patients put forward for this face a life that is limited by cancer but this allows them to have an added quality of life with less time spend in a clinical setting.”