Intrathecal Morphine Infusion Therapy in Management of Chronic Pain: Present and Future Implementation in Korea
Yonsei Medical Journal
;
: 475-481, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-21006
ABSTRACT
PURPOSE:
Intrathecal morphine pump (ITMP) infusion therapy is efficient in managing malignant and nonmalignant chronic pain refractory to standard treatment. However, the high cost of an ITMP is the greatest barrier for starting a patient on ITMP infusion therapy. Using the revised Korean reimbursement guidelines, we investigated the cost effectiveness of ITMP infusion therapy and conducted a patient survey. MATERIALS ANDMETHODS:
A retrospective chart review of 12 patients who underwent ITMP implantation was performed. Morphine dose escalation rates were calculated, and numeric rating scale (NRS) scores were compared before and after ITMP implantation. We surveyed patients who were already using an ITMP as well as those who were candidates for an ITMP. All survey data were collected through in-person interviews over 3 months. Data on the cost of medical treatment were collected and projected over time.RESULTS:
The NRS score decreased during the follow-up period. The median morphine dose increased by 36.9% over the first year, and the median time required to reach a financial break-even point was 24.2 months. Patients were more satisfied with the efficacy of ITMP infusion therapy than with conventional therapy. The expected cost of ITMP implantation was KRW 4000000-5000000 in more than half of ITMP candidates scheduled to undergo implantation.CONCLUSION:
The high cost of initiating ITMP infusion therapy is challenging; however, the present results may encourage more patients to consider ITMP therapy.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Injeções Espinhais
/
Bombas de Infusão Implantáveis
/
Inquéritos e Questionários
/
Estudos Retrospectivos
/
Resultado do Tratamento
/
Satisfação do Paciente
/
Análise Custo-Benefício
/
República da Coreia
/
Dor Crônica
/
Manejo da Dor
Tipo de estudo:
Guia de Prática Clínica
/
Estudo observacional
/
Pesquisa qualitativa
Limite:
Adulto
/
Idoso
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Yonsei Medical Journal
Ano de publicação:
2016
Tipo de documento:
Artigo
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