Multidimensional Analysis of Quality of Life in Patients with Chronic Non-Cancer Pain and Short- and Long-Term Intrathecal Analgesic Therapy

Abstract

Background: Intrathecal drug delivery (IDD) is part of the fourth analgesic step. Evidence on the quality of life of patients with refractory chronic non-cancer pain (CNCP) using these devices and their long-term outcomes is scarce. This study aims to evaluate patients with IDD to assess their HRQoL. Additionally, the study seeks to understand the patients' satisfaction with the treatment and changes in pain magnitude over time. Methods: Adult patients with CNCP and intrathecal drug delivery systems (IDDS) were included. The study population was divided into two groups: less than and more than 15 years of treatment. HRQoL was analyzed using validated questionnaires. Pain reduction was assessed using the visual analog scale (VAS), and treatment satisfaction was evaluated using the Patient Global Impression of Improvement scale. Results: The results indicate a poor HRQoL in IDD patients, with better scores in the group with ≥15 years of treatment. Pain reduction was similar in both groups, and patients reported a positive satisfaction level with the treatment. Conclusions: HRQoL in CNCP patients is severely affected. Long-term IDD patients have a similar or even better HRQoL in some respects compared to those with shorter follow-ups. IDD patients experienced pain reduction, with most feeling better or much better.

Keywords: chronic low back pain; chronic non-cancer pain; chronic non-malignant pain; health-related quality of life; intrathecal drug delivery systems; intrathecal infusion; intrathecal infusion systems; intrathecal pumps; long-term spinal pain; morphine; ziconotide.

Figure 1

Flow chart of patient selection for the sample.

Figure 2

Health-related quality of life (HRQoL) questionnaires among patients receiving IDD for CNCP for ≥15 years (blue bars), <15 years (red bars), and global (grey bars). Mean (SD) results for (a) SF-12 questionnaire; (b) MCS-12 questionnaire; (c) PCS-12 questionnaire; (d) BPI-SF questionnaire; (e) EQ-5D-5L index questionnaire; (f) EQ-5D VAS questionnaire.

Figure 3

VAS score relative reduction among patients with IDD for CNCP for ≥15 years (blue bars), <15 years (red bars), and global (grey bars) expressed as mean (SD).