Transdermal Fentanyl System May Improve Post-Op Mobility

NATIONAL HARBOR — A portable transdermal fentanyl delivery system was comparable in efficacy and tolerability to intravenous patient-controlled analgesia and may offer improved mobility in post-operative pain patients, study findings indicate.

“Immobility in the postoperative setting can increase complications, increase the length of stay, and increase costs. Early and enhanced mobilization can reduce the cost of care while improving patient outcomes,” Ali Oliashirazi, MD, of Marshall University in West Virginia, said during a poster session at the American Academy of Pain Medicine 2015 meeting.

Oliashirazi and colleagues conducted a pooled analysis of 1,882 patients from three randomized, controlled clinical trials comparing the efficacy of a portable fentanyl HCl Iontophoretic Transdermal System (fentanyl ITS; The Medicines Company) to intravenous patient-controlled analgesia (IV PCA) with morphine. Patient mobility was assessed using the Patient Ease of Care Questionnaire responses from patients, patient’s nurses, and physical therapist involved in patient care.

On patient questionnaires conducted in all three studies, fentanyl ITS significantly improved overall mobility across all demographics and surgery types assessed (abdominal, gynecological, orthopedic, other; P<0.0001), the researchers found.

In all three studies, survey data indicated that nurses found the fentanyl ITS less time-consuming and bothersome (P<0.0001 for both) than morphine IV PCA for activities pertaining to patient mobility (positioning, moving or transferring the patient).

In the two studies in which it was utilized, the physical therapist Ease of Care Questionnaire responses indicated the fentanyl ITS system had no negative impact on transferring patients to chairs, and ambulating patients both in and out of the room (P<0.0001 for all).

“The results of this pooled analysis suggest that patients treated with fentanyl ITS have greater post-operative mobility than patients treated with morphine IV PCA, which may lead to better outcomes,” Oliashirazi said. “Incorporation of this strategy into post-operative pain management protocols may significantly improve post-operative mobility.”

Reference

1. Oliashirazi A et al. #130. “Patient-Controlled Fentanyl Iontophoretic Transdermal System (Fentanyl ITS) Improved Postoperative Mobility Compared to Intravenous Patient-Controlled Analgesia (IV PCA) Morphine: A Pooled Analysis of Randomized, Controlled Trials.” Presented at: AAPM 2015. March 19-22, 2015; National Harbor, Maryland.

Disclosure: The study funding and analyses were supported financially by The Medicines Company.