PAINscape-Exploring patient experiences with ketamine for chronic neuropathic pain: A qualitative study

Chronic pain affects approximately 8 million Canadians annually and is defined by persistent pain lasting over 3 months. Ketamine is an anesthetic drug used to treat chronic neuropathic pain, a subset of chronic pain. To better understand ketamine's therapeutic benefits and feasibility as a treatment for chronic neuropathic pain, it is important to characterize patient experiences and perspectives with ketamine, as well as barriers and facilitators to accessing this treatment.

Thirteen participants were recruited from the chronic pain ketamine infusion program at St. Michael's Hospital in Toronto, Canada. Each participant completed a survey that captured demographic information and chronic pain features, followed by a semistructured interview. Interview data were analyzed, and themes were generated using content analysis.

All participants described decreased pain intensity and increased functionality after receiving ketamine treatment. Barriers to ketamine treatment included fragmented health systems and long wait times, along with a struggle for pain validation by health care providers. Facilitators of ketamine treatment included support from individual health care providers and the provision of a supportive treatment environment.

Although pain experiences differed among participants, all participants reported decreased pain with ketamine infusions. Addressing the stigma associated with ketamine infusions, further research around augmenting durability of ketamine, and providing a safe treatment environment can all improve ketamine's benefit for chronic neuropathic pain. Understanding the barriers and facilitators, as well as implementing participant suggestions, will not only help inform our ketamine program but can improve access to pain management and facilitate future research in this field.