{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:03:57Z","timestamp":1785175437699,"version":"3.55.0"},"reference-count":67,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Foundation Flanders (FWO)","award":["FWOTBM15 - T000525N"],"award-info":[{"award-number":["FWOTBM15 - T000525N"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Intrathecal drug delivery (IDD) offers a therapeutic option for patients suffering from refractory pain or severe spasticity. By allowing targeted and continuous infusion directly into the intrathecal space, IDD bypasses the blood-brain barrier and enhances therapeutic effectiveness of the drug. Following the implantation of an IDD pump, the most commonly performed postoperative maintenance procedure is the pump refill (at regular intervals). This process can be burdensome for patients, affects their comfort, and carries significant risks. The current aim of this study is to evaluate whether intrathecal pump refills performed at home provide a difference in patient comfort compared to refills conducted in the hospital.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The IMPROVE study is a monocentric, randomized controlled crossover trial, including 82 patients. For this study, each patient will undergo four intrathecal pump refill procedures (two at home and two in the outpatient clinic) allocated in a randomized order. The primary objective of this study is to determine whether at-home refills provide a difference in patient comfort compared to hospital-based refills. Secondary objectives include assessing differences in quality of life, pain, stress, anxiety, self-efficacy, caregiver burden, patient preferences, safety, and overall cost-effectiveness between the two settings. Patients will be followed over the course of four intrathecal pump refills, which is estimated to span approximately one year.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Within the IMPROVE project, pump refills will be performed through hospital at home. If at-home intrathecal pump refills prove more comfortable for patients and cost-effective for society, this would strengthen the patient-centred care model and support adopting this approach as the new standard treatment for IDD patients. A graphical abstract is provided in the supplementary materials (S1 Fig).<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n \n Details on the study site can be found at ISRCTN with identifier: ISRCTN18031921; [href:\n https:\/\/doi.org\/10.1186\/ISRCTN18031921<\/jats:ext-link>\n ]\n https:\/\/doi.org\/10.1186\/ISRCTN18031921<\/jats:ext-link>\n . The trial was registered in the ISRCTN registry on 18 November 2025.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0354092","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:28:53Z","timestamp":1785173333000},"page":"e0354092","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intrathecal pump refills at home or at the hospital: Protocol for a randomized controlled crossover trial\u2014The IMPROVE study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9864-7683","authenticated-orcid":true,"given":"Ulrike","family":"Van Hoey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7794-4490","authenticated-orcid":true,"given":"Britt","family":"Winnepenninckx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0577-5449","authenticated-orcid":true,"given":"Maarten","family":"Moens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Putman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2271-9855","authenticated-orcid":true,"given":"Lisa","family":"Goudman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"pone.0354092.ref001","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/j.neurom.2022.03.003","article-title":"Effectiveness and safety of intrathecal drug delivery systems for the management of cancer pain: a systematic review and meta-analysis","author":"R Duarte","year":"2023","journal-title":"Neuromodulation"},{"issue":"2","key":"pone.0354092.ref002","doi-asserted-by":"crossref","first-page":"186","DOI":"10.21037\/atm-20-3814","article-title":"Narrative review of intrathecal drug delivery (IDD): indications, devices and potential complications","volume":"9","author":"MA Capozza","year":"2021","journal-title":"Ann Transl Med"},{"key":"pone.0354092.ref003","first-page":"615","article-title":"Current perspectives on intrathecal drug delivery","volume":"7","author":"MM Bottros","year":"2014","journal-title":"J Pain Res"},{"issue":"7","key":"pone.0354092.ref004","article-title":"Evaluating community-based intrathecal baclofen therapy: effectiveness, safety, and feasibility","volume":"13","author":"SME van der Gaag","year":"2024","journal-title":"J Clin Med"},{"key":"pone.0354092.ref005","article-title":"The management of spasticity in adults","author":"KPS Nair","year":"2014","journal-title":"BMJ"},{"issue":"2","key":"pone.0354092.ref006","doi-asserted-by":"crossref","first-page":"124","DOI":"10.2500\/ajra.2015.29.4149","article-title":"The blood-brain barrier and nasal drug delivery to the central nervous system","volume":"29","author":"MM Miyake","year":"2015","journal-title":"Am J Rhinol Allergy"},{"key":"pone.0354092.ref007","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.neurom.2021.12.004","article-title":"Management of cancer-related pain with intrathecal drug delivery: a systematic review and meta-analysis of clinical studies","author":"C Perruchoud","year":"2023","journal-title":"Neuromodulation"},{"key":"pone.0354092.ref008","author":"M Gofeld"},{"issue":"7","key":"pone.0354092.ref009","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/ner.13225","article-title":"Managing a national intrathecal pump service during the COVID-19 pandemic","volume":"23","author":"AK Patel","year":"2020","journal-title":"Neuromodulation"},{"key":"pone.0354092.ref010","doi-asserted-by":"crossref","unstructured":"Coffey RJ, Ridgely PL. Abrupt intrathecal baclofen withdrawal: management of potentially life-threatening sequelae. 2001.","DOI":"10.1046\/j.1525-1403.2001.00142.x"},{"issue":"7","key":"pone.0354092.ref011","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1111\/anae.15076","article-title":"Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel","volume":"75","author":"H Shanthanna","year":"2020","journal-title":"Anaesthesia"},{"issue":"22","key":"pone.0354092.ref012","doi-asserted-by":"crossref","DOI":"10.3390\/jcm10225353","article-title":"Hospital at home for intrathecal pump refills: a prospective effectiveness, safety and feasibility study","volume":"10","author":"L Goudman","year":"2021","journal-title":"J Clin Med"},{"issue":"7","key":"pone.0354092.ref013","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1111\/ner.13038","article-title":"Efficiency and safety of aftercare with intrathecal baclofen on location","volume":"22","author":"SME Goslinga-van der Gaag","year":"2019","journal-title":"Neuromodulation"},{"key":"pone.0354092.ref014","doi-asserted-by":"crossref","unstructured":"Mowbray CT, Holter MC, Teague GB, Bybee D. 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Cross-cultural psychometric evaluation of the Dutch McGillQoL questionnaire for breast cancer patients. 2016."},{"key":"pone.0354092.ref019","unstructured":"Cohen R, Fellow R, Mcgill M, Hospital RV. The McGill Quality of Life Questionnaire: A Measure of Quality of Life Appropriate for People with Advanced Disease. A Preliminary Study of Validity and Acceptability. 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Analysis of Cost Data. 2022."},{"issue":"16","key":"pone.0354092.ref046","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18168330","article-title":"Cost-effectiveness of colorectal cancer genetic testing","volume":"18","author":"AR Ramdzan","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0354092.ref047","doi-asserted-by":"crossref","DOI":"10.1017\/S0266462321001732","article-title":"Consolidated health economic evaluation reporting standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations","volume":"38","author":"D Husereau","year":"2022","journal-title":"Int J Technol Assess Health Care"},{"issue":"6","key":"pone.0354092.ref048","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1017\/S0266462314000725","article-title":"Belgian guidelines for economic evaluations: second edition","volume":"30","author":"N Thiry","year":"2014","journal-title":"Int J Technol Assess Health Care"},{"issue":"5","key":"pone.0354092.ref049","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1177\/0272989X12455463","article-title":"State-transition modeling: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force-3","volume":"32","author":"U Siebert","year":"2012","journal-title":"Med Decis Making"},{"issue":"4","key":"pone.0354092.ref050","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1080\/14737167.2022.2014324","article-title":"Evaluating discrete choice experiment willingness to pay [DCE-WTP] analysis and relative social willingness to pay [RS-WTP] analysis in a health technology assessment of a treatment for an ultra-rare childhood disease [CLN2]","volume":"22","author":"D Moro","year":"2022","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"issue":"4","key":"pone.0354092.ref051","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jval.2016.04.004","article-title":"Statistical Methods for the Analysis of Discrete Choice Experiments: A Report of the ISPOR Conjoint Analysis Good Research Practices Task Force","volume":"19","author":"AB Hauber","year":"2016","journal-title":"Value Health"},{"key":"pone.0354092.ref052","doi-asserted-by":"crossref","article-title":"Telemedicine and remote monitoring in neuromuscular diseases: challenges and opportunities.","author":"F Torri","DOI":"10.1177\/22143602251330436"},{"key":"pone.0354092.ref053","unstructured":"Nipp RD, Gaufberg E, Vyas C, Azoba C, Qian CL, Jaggers J, et al. Full-length article available online at. JCO Oncol Pract [Internet]. Report."},{"issue":"4","key":"pone.0354092.ref054","doi-asserted-by":"crossref","first-page":"141","DOI":"10.36401\/JQSH-21-4","article-title":"Hospital at Home: An Evolving Model for Comprehensive Healthcare","volume":"4","author":"HY Patel","year":"2021","journal-title":"Glob J Qual Saf Healthc"},{"issue":"3","key":"pone.0354092.ref055","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1007\/s11606-021-07065-0","article-title":"Perceptions of Hospital-at-Home Among Stakeholders: a Meta-synthesis","volume":"37","author":"CMS Chua","year":"2022","journal-title":"J Gen Intern Med"},{"issue":"7","key":"pone.0354092.ref056","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1111\/jgs.16486","article-title":"Choosing inpatient vs home treatment: why patients accept or decline hospital at home","volume":"68","author":"P Saenger","year":"2020","journal-title":"J Am Geriatr Soc"},{"key":"pone.0354092.ref057","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1111\/1468-0009.12586","article-title":"Hospital-at-Home: Multistakeholder Considerations for Program Dissemination and Scale","author":"KT Kadakia","year":"2022","journal-title":"Milbank Quarterly"},{"issue":"7","key":"pone.0354092.ref058","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1007\/s11606-020-06416-7","article-title":"Hospital-level care at home for acutely ill adults: a qualitative evaluation of a randomized controlled trial","volume":"36","author":"DM Levine","year":"2021","journal-title":"J Gen Intern Med"},{"issue":"3","key":"pone.0354092.ref059","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1111\/jgs.15653","article-title":"Hospital at Home-Plus: A Platform of Facility-Based Care","volume":"67","author":"LV DeCherrie","year":"2019","journal-title":"J Am Geriatr Soc"},{"issue":"474","key":"pone.0354092.ref060","first-page":"9","article-title":"Patient and carer satisfaction with \u201chospital at home\u201d: quantitative and qualitative results from a randomised controlled trial","volume":"52","author":"A Wilson","year":"2002","journal-title":"Br J Gen Pract"},{"issue":"3","key":"pone.0354092.ref061","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s11606-022-07765-1","article-title":"Experiences of patients and their caregivers admitted to a hospital-at-home program in Singapore: a descriptive qualitative study","volume":"38","author":"SQ Ko","year":"2023","journal-title":"J Gen Intern Med"},{"issue":"6","key":"pone.0354092.ref062","article-title":"Association of Costs and Days at Home With Transfer Hospital in Home","volume":"4","author":"S Cai","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"1","key":"pone.0354092.ref063","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s12185-021-03219-2","article-title":"Implementation of a hospital-at-home (HAH) unit for hematological patients during the COVID-19 pandemic: safety and feasibility","volume":"115","author":"I G\u00f3mez-Centuri\u00f3n","year":"2022","journal-title":"Int J Hematol"},{"issue":"6","key":"pone.0354092.ref064","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0129282","article-title":"Efficacy of Hospital at Home in Patients with Heart Failure: A Systematic Review and Meta-Analysis","volume":"10","author":"A Qaddoura","year":"2015","journal-title":"PLoS One"},{"issue":"7","key":"pone.0354092.ref065","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.ejheart.2008.05.012","article-title":"Home care as an option in worsening chronic heart failure -- a pilot study to evaluate feasibility, quality adjusted life years and cost-effectiveness","volume":"10","author":"H Patel","year":"2008","journal-title":"Eur J Heart Fail"},{"key":"pone.0354092.ref066","unstructured":"Tibaldi V, Isaia G, Scarafiotti C, Gariglio F, Zanocchi M, Bo M. Health care reform hospital at home for elderly patients with acute decompensation of chronic heart failure a prospective randomized controlled trial. 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