The Control Workflow℠ for Targeted Drug Delivery (TDD) is an approach to help eliminate systemic opioids and provide effective pain relief. The purpose of this workflow is to provide a treatment option for chronic pain using low-dose TDD. Patients should receive appropriate pain treatment based on careful consideration of benefits and risks of treatment options.
TDD has demonstrated a substantial reduction in the amount of drug required to effectively manage chronic pain. By having an outlined workflow, we are hoping to reduce perceived barriers to the TDD therapy.1
Although TDD can be used for many different types of pain, consider this selection criteria for the Control Workflow℠:
A complete taper of systemic opiate medication and a drug “holiday” will allow you to titrate to the lowest effective dose and manage dose escalation. The opioid holiday has been shown to drive lower initial dose compared to similar studies without a holiday.
The Control Workflow℠ aims to phase out systemic opioids and provide effective pain relief using intrathecal opioids delivered by an implanted programmable pump and catheter. Once the pump is in place, it may take several months to optimize drug delivery.
Safety protocols enable you and your team to react quickly and effectively to potential concerns. Whenever initiating a bolus or dose adjustment, make sure to monitor the patient for adverse reactions.
Ruan X. Drug-related side effects of long-term intrathecal morphine therapy. Pain Physician. 2007;10:357-366.
Medtronic data on file.
Grider JS. Harned ME, Etscheidt MA. Patient selection and outcomes using a low-dose intrathecal opioid trialing method for chronic nonmalignant pain. Pain Physician. 2011;14:343-351.
Netter F. Atlas of Human Anatomy. 5th ed. Philadelphia. PA: Saunders Elsevier. 2010.