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


Goebel, Andreas; Barker, Chris; Birklein, Frank; Brunner, Florian; Casale, Roberto; Eccleston, Chris; Eisenberg, E; McCabe, Candy S; Moseley, G Lorimer; Perez, R; Perrot, Serge; Terkelsen, Astrid; Thomassen, Ilona; Zyluk, Andrzey; Wells, Chris (2019). Standards for the diagnosis and management of complex regional pain syndrome: Results of a European Pain Federation task force. European Journal of Pain, 23(4):641-651.

Abstract

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

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

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

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

This position statement summarizes expert opinion on acceptable standards for CRPS care in Europe.

Abstract

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

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

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

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

This position statement summarizes expert opinion on acceptable standards for CRPS care in Europe.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Anesthesiology and Pain Medicine
Language:English
Date:April 2019
Deposited On:07 Feb 2020 14:22
Last Modified:29 Jul 2020 10:32
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1090-3801
OA Status:Hybrid
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1002/ejp.1362
PubMed ID:30620109

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