Development of a self-management manual for patients with refractory cancer pain treated with a semi-implantable intrathecal drug delivery system: a Delphi study

Lanlan Shen; Yachen Chu; Ying Li; Yong Ni; Yue Zhang; Xiaomei Song; Xuling Pan

doi:10.1007/s00520-026-10684-0

Development of a self-management manual for patients with refractory cancer pain treated with a semi-implantable intrathecal drug delivery system: a Delphi study

Support Care Cancer. 2026 Apr 24;34(5):463. doi: 10.1007/s00520-026-10684-0.

Authors

Lanlan Shen^#¹, Yachen Chu^#¹, Ying Li², Yong Ni¹, Yue Zhang¹, Xiaomei Song³, Xuling Pan⁴

Affiliations

¹ Department of Pain, The Second Affiliated Hospital of Soochow University, No.1055 of SanXiang Road, SuZhou District, Suzhou, Jiangsu Province, 215004, China.
² Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China.
³ Department of Nursing, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215004, China.
⁴ Department of Pain, The Second Affiliated Hospital of Soochow University, No.1055 of SanXiang Road, SuZhou District, Suzhou, Jiangsu Province, 215004, China. panxulingxlp@163.com.

^# Contributed equally.

PMID: 42029758
DOI: 10.1007/s00520-026-10684-0

Abstract

Objective: The aim of this study was to develop a self-management manual for individuals with refractory cancer pain treated with a semi-implantable intrathecal drug delivery system (IDDS), using the Delphi method.

Methods: An initial draft of the self-management manual was developed through a comprehensive literature review and expert panel discussions. The Delphi method was used to conduct two rounds of expert consultations with a total of 23 experts covering pain management, oncology, palliative care, and oncology nursing aimed at refining and finalizing the content of the manual, which fully guarantees the professionalism and comprehensiveness of expert opinions.

Results: Two rounds of expert consultation were completed, yielding a 100% response rate in both instances. The authority coefficients for the participating experts were 0.881 and 0.890, respectively. Coefficients of variation ranged from 0.09 to 0.24 in the first round and 0.06-0.18 in the second. Kendall's coefficients of concordance were 0.174 and 0.215, respectively (both p < 0.001), indicating statistically significant agreement among experts. The finalized manual comprised 5 primary domains, 22 secondary domains, and 40 tertiary items.

Conclusion: The development of the self-management manual through the Delphi method demonstrated high levels of expert engagement, authority, and consensus. The resulting manual is systematic and comprehensive, providing practical guidance for home-based analgesia management in patients with semi-implantable IDDSs, and may support multidisciplinary care teams in clinical practice. While the current study establishes proof-of-concept for the manual, its clinical translation will involve subsequent pilot testing in clinical settings, prospective validation in large patient cohorts, and iterative optimization based on clinical feedback and real-world application effects.

Keywords: Continuity of care; Delphi method; Home care; Refractory cancer pain; Self-management; Semi-implantable intrathecal drug delivery system.

MeSH terms

Cancer Pain* / drug therapy
Delphi Technique
Drug Delivery Systems*
Humans
Infusion Pumps, Implantable
Injections, Spinal
Intractable Pain* / drug therapy
Intractable Pain* / etiology
Pain Management* / methods
Palliative Care / methods
Self-Management* / methods