Development and Evaluation of a Pharmaceutical Care Pathway for Managing Cancer Pain at Home with Implanted Intrathecal Drug Delivery Systems (IDDS) (Preprint)

BACKGROUND Intrathecal infusion therapy, internationally recognized as the best treatment for intractable pain. However, owing to the high risk and uncertainty of intraspinal drug trials, clinical trials of intraspinal drug administration are strictly controlled, which may lead to the occurrence of "off-label" intraspinal drug use in current analgesic therapy. Ensuring the analgesic efficacy and safety of these drugs requires further exploration by pharmacists and clinicians. OBJECTIVE Utilizing a mobile information cancer pain management platform, this study aims to establish a pharmaceutical manage pathway for patients managing cancer pain at home with an Intrathecal Drug Delivery System (IDDS) and to assess its clinical effect. METHODS A retrospective analysis was conducted on 10 cancer patients with an IDDS implanted without pharmaceutical care (control group) and 10 patients with pharmaceutical care (intervention group). The monitoring period spanned from the first day of admission to 1 week post-discharge. A comparative analysis was performed on pain control, medication compliance, quality of life, and the incidence of adverse reactions between the two groups. RESULTS The 24h minimum and 24h average pain scores were significantly lower in the intervention group 1 day after surgery (P<0.05), although there was no significant improvement in reducing DN4 score, improving pain relief rate, medication compliance, appetite and quality of life self-score in the intervention group. One week after discharge, the bodily pain (BP) score in the SF-36 scale of the intervention group significantly increased (P<0.05). One week after discharge, there was no significant difference in the incidence of adverse reactions between the two groups (2=3.28, P>0.05). CONCLUSIONS Implementation of a pharmaceutical care pathway based on a mobile information cancer pain management platform effectively reduced postoperative pain scores in home cancer patients with IDDS implantation. It also enhances medication compliance and end-stage quality of life, demonstrating its potential for widespread application and further promotion.