Name of the Procedure:

Home Infusion Therapy for Implanted Pump Pain Management Infusion
Common name(s): Home Infusion for Pain Management
Technical/Medical term: Home Infusion Therapy, Implanted Pump Pain Management Infusion

Summary

Home infusion therapy involves administering medication directly into the bloodstream via an implanted pump to manage chronic pain. This service includes administrative and professional pharmacy services, care coordination, and all necessary supplies and equipment, with nursing visits and drugs coded separately.

Purpose

This procedure addresses chronic pain conditions that are not adequately managed by oral or other routes of analgesia. The goal is to provide continuous pain relief, improve the patient's quality of life, and minimize the side effects of oral pain medications.

Indications

• Persistent, severe chronic pain conditions such as cancer pain, neuropathic pain, or non-malignant pain syndromes.
• Patients not responsive to or intolerant of oral pain medications.
• Specific medical conditions diagnosed by a healthcare provider warranting continuous pain management.

Preparation

• Pre-procedure assessment by the healthcare team, including pain evaluation and overall medical history.
• Fasting may not be required, but specific instructions will be provided based on the individual's condition.
• Diagnostic tests such as blood work or imaging may be required to determine suitability for the procedure.

Procedure Description

1. Initial evaluation and prescription by a pain management specialist.
2. Coordination with a pharmacy to prepare the medication for home delivery.
3. A nurse or specialized healthcare provider will make home visits to manage the infusion pump and provide necessary care and education to the patient and caregivers.
4. The implanted pump continuously delivers pain medication directly into the bloodstream.
5. Regular follow-up and monitoring, adjusting medication dosages as needed.

Tools/Equipment: Implanted infusion pump, medication, infusion supplies (tubing, needles, etc.), monitoring and emergency response equipment.

Anesthesia/Sedation: Not applicable for the ongoing administration phase; localized anesthesia may be used during the initial pump implantation.

Duration

The duration of therapy is individualized, ranging from weeks to lifelong treatment, depending on the patient's condition and response to the treatment.

Setting

• The bulk of the infusion therapy is managed at the patient's home.
• Initial pump implantation occurs in a hospital or outpatient surgical center.

Personnel

• Pain Management Specialist
• Home Health Nurses
• Pharmacists
• Care Coordinators

Risks and Complications

Common Risks:

• Infection at the pump site
• Blockage or displacement of the pump catheter
• Local irritation or skin issues

Rare Risks:

• Severe infection (sepsis)
• Allergic reaction to the infused medication
• Pump malfunction

Management of Complications: Prompt medical intervention, appropriate use of antibiotics, replacement or repositioning of the pump catheter if necessary.

Benefits

• Continuous and consistent pain relief
• Improved functionality and quality of life
• Reduced side effects compared to oral pain medications Patients often experience noticeable pain relief within days to weeks of therapy initiation.

Recovery

• Regular monitoring and follow-up visits required.
• Instructions for care and maintenance of the infusion site.
• Potential lifestyle adjustments recommended to ensure the proper functioning of the pump.
• Recovery from initial pump implantation surgery typically involves a few days of rest and limited physical activity.

Alternatives

• Oral or transdermal pain medications
• Physical therapy and other non-pharmacological pain management strategies
• Spinal cord stimulators
• Pros and cons: Oral medications might be easier to administer but may have more systemic side effects; non-pharmacological treatments may not provide adequate relief for severe pain.

Patient Experience

• During the procedure: The patient may feel the initial discomfort of pump implantation surgery.
• After the procedure: Patients usually feel significant pain relief. There may be some soreness or discomfort around the pump implantation site initially.
• Pain Management: Pain medications for any post-operative discomfort, patient education on using the pump, and 24/7 support for any issues or questions about the infusion therapy.