| Practice choices and challenges in the current intrathecal therapy environment: an online survey. | |
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MedLine Citation:
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PMID: 19254334 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study was to evaluate current practice characteristics, treatment choices, clinical experiences, and economic concerns associated with intrathecal therapy. DESIGN: Health care professionals in the United States, who were known to actively use intrathecal therapy in their practices, were recruited to participate in an online survey; contact information was obtained via Internet searches, university Websites, association memberships, industry databases, and personal contacts. Survey responses were summarized descriptively. RESULTS: Of the 329 practitioners who were contacted, 87 participated in the survey. Most participants specialized in anesthesiology (77.0%), worked in a private practice or private hospital (74.7%), and had been practicing pain management for more than 10 years (64.4%). Morphine was the most frequently used opioid for the initiation of intrathecal therapy (80.7% of practitioners), and 81.9% had used ziconotide in their practice. Most practitioners (63.9%) had treated at least one patient who developed a granuloma, and 66.0% of those practitioners had a patient experience permanent or temporary neurological injury due to a granuloma. Fewer than half of practitioners were satisfied with reimbursement from private insurance companies (25.3%) or workers compensation (34.9%), and 90.5% believed reimbursement rates for filling, refilling, and programming patient pumps are not adequate to cover practice costs. The majority of practitioners (56.6%) use fewer pumps in their practices because of reimbursement issues. CONCLUSIONS: Intrathecal pain management practices continue to evolve as the options for treatment increase, and the body of applicable scientific literature grows; however, economic considerations can influence clinical decisions and may interfere with treatment choice and patient access to therapy. |
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Authors:
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Timothy R Deer; Elliot Krames; Robert M Levy; Samuel J Hassenbusch; Joshua P Prager |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-02-25 |
Journal Detail:
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Title: Pain medicine (Malden, Mass.) Volume: 10 ISSN: 1526-4637 ISO Abbreviation: Pain Med Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100894201 Medline TA: Pain Med Country: United States |
Other Details:
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Languages: eng Pagination: 304-9 Citation Subset: IM |
Affiliation:
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The Center for Pain Relief, Charleston, West Virginia, USA. doctdeer@aol.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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