Standards for the diagnosis and management of complex regional pain syndrome: Results of a European Pain Federation task force.


Journal

European journal of pain (London, England)
ISSN: 1532-2149
Titre abrégé: Eur J Pain
Pays: England
ID NLM: 9801774

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 07 09 2018
revised: 03 01 2019
accepted: 04 01 2019
pubmed: 9 1 2019
medline: 14 6 2019
entrez: 9 1 2019
Statut: ppublish

Résumé

Complex regional pain syndrome is a painful and disabling post-traumatic primary pain disorder. Acute and chronic complex regional pain syndrome (CRPS) are major clinical challenges. In Europe, progress is hampered by significant heterogeneity in clinical practice. We sought to establish standards for the diagnosis and management of CRPS. The European Pain Federation established a pan-European task force of experts in CRPS who followed a four-stage consensus challenge process to produce mandatory quality standards worded as grammatically imperative (must-do) statements. We developed 17 standards in 8 areas of care. There are 2 standards in diagnosis, 1 in multidisciplinary care, 1 in assessment, 3 for care pathways, 1 in information and education, 4 in pain management, 3 in physical rehabilitation and 2 on distress management. The standards are presented and summarized, and their generation and consequences were discussed. Also presented are domains of practice for which no agreement on a standard could be reached. Areas of research needed to improve the validity and uptake of these standards are discussed. The European Pain Federation task force present 17 standards of the diagnosis and management of CRPS for use in Europe. These are considered achievable for most countries and aspirational for a minority of countries depending on their healthcare resource and structures. This position statement summarizes expert opinion on acceptable standards for CRPS care in Europe.

Sections du résumé

BACKGROUND BACKGROUND
Complex regional pain syndrome is a painful and disabling post-traumatic primary pain disorder. Acute and chronic complex regional pain syndrome (CRPS) are major clinical challenges. In Europe, progress is hampered by significant heterogeneity in clinical practice. We sought to establish standards for the diagnosis and management of CRPS.
METHODS METHODS
The European Pain Federation established a pan-European task force of experts in CRPS who followed a four-stage consensus challenge process to produce mandatory quality standards worded as grammatically imperative (must-do) statements.
RESULTS RESULTS
We developed 17 standards in 8 areas of care. There are 2 standards in diagnosis, 1 in multidisciplinary care, 1 in assessment, 3 for care pathways, 1 in information and education, 4 in pain management, 3 in physical rehabilitation and 2 on distress management. The standards are presented and summarized, and their generation and consequences were discussed. Also presented are domains of practice for which no agreement on a standard could be reached. Areas of research needed to improve the validity and uptake of these standards are discussed.
CONCLUSION CONCLUSIONS
The European Pain Federation task force present 17 standards of the diagnosis and management of CRPS for use in Europe. These are considered achievable for most countries and aspirational for a minority of countries depending on their healthcare resource and structures.
SIGNIFICANCE CONCLUSIONS
This position statement summarizes expert opinion on acceptable standards for CRPS care in Europe.

Identifiants

pubmed: 30620109
doi: 10.1002/ejp.1362
pmc: PMC6593444
doi:

Types de publication

Journal Article Practice Guideline Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

641-651

Informations de copyright

© 2019 European Pain Federation - EFIC®.

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Auteurs

Andreas Goebel (A)

Walton Centre NHS Foundation Trust, Liverpool, UK.
Pain Research Institute, University of Liverpool, Liverpool, UK.

Chris Barker (C)

Walton Centre NHS Foundation Trust, Liverpool, UK.
Pain Research Institute, University of Liverpool, Liverpool, UK.

Frank Birklein (F)

Department of Neurology, University of Mainz, Mainz, Germany.

Florian Brunner (F)

Physical Medicine and Rheumatology, Balgrist University Hospital, Zurich, Switzerland.

Roberto Casale (R)

Pain Rehabilitation Unit, Habilita Hospitals, Zingonia di Ciserano, Italy.

Chris Eccleston (C)

Centre for Pain Research, The University of Bath, Bath, Uk.
Department of Clinical and Health Psychology, Ghent University, Ghent, Belgium.
European Pain Federation, Brussels, Belgium.

E Eisenberg (E)

Rambam Health Care Campus, Institute of Pain Medicine, Haifa, Israel.

Candy S McCabe (CS)

Florence Nightingale Foundation Clinical Professor of Nursing, University of West of England, Bristol & Royal United Hospitals NHS Foundation Trust, Bath, UK.

G Lorimer Moseley (GL)

Sansom Institute, University of South Australia, Adelade, Australia.

R Perez (R)

Department of Anaesthesiology, VU University Medical Center, Amsterdam, Netherlands.

Serge Perrot (S)

Pain Center, Cochin Hospital, Paris Descartes University, Paris, France.

Astrid Terkelsen (A)

Danish Pain Research Center and Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.

Ilona Thomassen (I)

Patiëntenvereniging CRPS, Nijmegen, The Netherlands.

Andrzey Zyluk (A)

Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland.

Chris Wells (C)

European Pain Federation, Brussels, Belgium.

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