World Institute of Pain

Urgent Message: Letter from the President

What do Hurricane Katrina, Superstorm Sandy and now the severe weather patterns noted throughout the United States and Europe have to do with chronic pain patients?
Each carries the risk of causing an unanticipated emergency for patients with implanted pain pumps. Weather-related disruptions to the supply chain and service issues with delivery partners like UPS and FedEx can delay when patient prescriptions arrive from pharmacies. These delays, plus travel issues faced by patients and providers, can impact when patients get their pumps refilled.
Importantly, the abrupt cessation of intrathecal therapy can be life-threatening. This is true for chronic pain patients but especially for those using this therapy to manage spasticity.

We urge every provider to be proactive in patient management during this period of severe weather. If you are managing implantable pump patients, it is important to partner with your current intrathecal compounding pharmacy to ensure every patient has a continuity of care plan. If there appears to be any prolonged disruptions in service, there are several steps that can be taken to avoid complications, including the following:
• Evaluate residual volume in the pump; it may provide a longer than calculated supply of drug
• Consider lowering the infusion rate proactively to extend the life of the drug in the pump and/or supplement with systemic medications
• If possible, use pharmacy providers that have extended Beyond Use Dates for their medications, allowing you to order in advance of any weather disruptions
• Finally, if necessary, consider alternative pharmacy partners to minimize disruption in care

Intrathecal therapy is a very valuable tool in our armamentarium against pain and it continues to have tremendous advantages over maximal medical management for many patients.

You can ensure medication continuity in severe weather, but your proactive attention now will avoid emergencies with the current, and any upcoming, storm.