Implementing measurement-based care in the analgesic management of cancer pain patients receiving intrathecal drug infusion

Purpose Effective analgesic management can enhance the quality of life for patients experiencing cancer pain. The objective of this study is to assess the effectiveness of measurement-based care (MBC) in the analgesic management of cancer pain patients receiving intrathecal drug infusion. Methods Patients experiencing moderate-to-severe cancer pain and receiving intravenous patient-controlled analgesia (IV-PCA) and then intrathecal morphine patient-controlled analgesia (IT-PCA) were included. Following the MBC strategy, a comprehensive pain assessment is conducted before the treatment using the Visual Analog Scale (VAS) and the brief pain inventory. Subsequently, pain intensity, side effects and quality of life were evaluated at the initiation of intravenous PCA, after intravenous PCA, following intrathecal PCA, and at 1, 3, and 6 months during the follow-up period. Results Fifteen patients with a VAS score ≥ 7 were enrolled. A total of 60% (9/15) had chest and back pain, and more than 40% (6/15) showed obvious persistent pain, 26.7% (4/15) accompanied by paroxysmal exacerbation. The mean VAS score before PCA with morphine (8.28 ± 0.76) was decreased by 44.28% to 3.85 ± 0.7 after IV-PCA. Following morphine infusion with IT-PCA, the VAS score further decreased to 2.14 ± 0.9, resulting in a pain reduction of 76.4%. Throughout the follow-up, pain relief was sustained and the patient's quality of life was improved. Conclusion The findings of this study indicated that implementing of intrathecal morphine control analgesic technology based on MBC strategy can lead to effective individualized analgesic treatment, reduce side effects and improve quality of life for cancer pain patients.