The efficacy of an interdisciplinary pain management program for complex regional pain syndrome compared to low back pain and chronic widespread pain: An observational study.

IF 2.9 3区 医学 Q1 ANESTHESIOLOGY Pain Medicine Pub Date : 2024-12-12 DOI:10.1093/pm/pnae126
Debbie J Bean, Natalie L Tuck, Nico Magni, Tipu Aamir, Catherine Pollard MHlthPrac, Gwyn N Lewis
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Abstract

Background: Little research has assessed the efficacy of interdisciplinary pain management programs (IPMPs) for complex regional pain syndrome (CRPS), whereas evidence shows that IPMPs are effective for low back pain (LBP) and chronic widespread pain (CWP). This study aimed to determine whether outcomes following an IPMP differ for people with CRPS compared to LBP and CWP. In addition, we determined whether it is possible to predict IPMP outcomes using baseline characteristics.

Methods: People with CRPS (N = 66) who had completed a 3-week IPMP were compared with age- and gender- matched controls with LBP (N = 66) and CWP (N = 66). Measures of pain intensity, pain interference and psychological factors were extracted for pre- and post-program, and at 1, 6 and 12 months. Latent class analysis identified recovery trajectories for pain intensity and pain interference. Chi-square analyses assessed differences between diagnostic groups in recovery trajectories. Machine learning models were implemented to predict recovery trajectories from baseline scores.

Results: Two recovery trajectories for each dependent variable (pain interference and for pain intensity) were identified: good responders and poorer responders. Following IPMPs, 37% of people belonged to a good responder recovery trajectory for pain interference, and 11% belonged to a good responder recovery trajectory for pain intensity. Recovery trajectories were equal across the three diagnostic groups (CRPS, LBP, CWP) for pain interference (χ2=1.8, p=0.4) and intensity (χ = 0.2, p=0.9). Modelling to predict outcomes correctly classified 69% of cases for pain interference and 88% of cases for pain intensity recovery trajectories using baseline scores.

Conclusion: People with CRPS, LBP, and CWP experience similar benefits following an IPMP. This supports the use of IPMPs for people with CRPS.

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与腰背痛和慢性广泛性疼痛相比,跨学科疼痛管理计划对复杂区域疼痛综合征的疗效:一项观察性研究。
背景:很少有研究评估跨学科疼痛管理计划(IPMP)对复杂性区域疼痛综合征(CRPS)的疗效,而有证据表明,跨学科疼痛管理计划对腰背痛(LBP)和慢性广泛性疼痛(CWP)有效。本研究旨在确定,与腰背痛和慢性广泛性疼痛相比,CRPS 患者接受 IPMP 后的疗效是否有所不同。此外,我们还确定是否有可能通过基线特征来预测 IPMP 的结果:方法:将完成为期 3 周 IPMP 的 CRPS 患者(66 人)与年龄和性别匹配的 LBP(66 人)和 CWP(66 人)对照组进行比较。研究人员提取了计划实施前、实施后、1 个月、6 个月和 12 个月时的疼痛强度、疼痛干扰和心理因素测量值。潜类分析确定了疼痛强度和疼痛干扰的恢复轨迹。卡方分析评估了不同诊断组在康复轨迹上的差异。采用机器学习模型从基线分数预测恢复轨迹:结果:针对每个因变量(疼痛干扰和疼痛强度)确定了两种恢复轨迹:良好反应者和较差反应者。接受 IPMP 治疗后,37% 的人在疼痛干扰方面属于良好反应者的恢复轨迹,11% 的人在疼痛强度方面属于良好反应者的恢复轨迹。三个诊断组(CRPS、LBP、CWP)的疼痛干扰(χ2=1.8,p=0.4)和疼痛强度(χ=0.2,p=0.9)的恢复轨迹相同。预测结果的模型使用基线评分对69%的疼痛干扰和88%的疼痛强度恢复轨迹病例进行了正确分类:结论:CRPS、LBP 和 CWP 患者在接受 IPMP 治疗后获得的益处相似。这支持对 CRPS 患者使用 IPMP。
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来源期刊
Pain Medicine
Pain Medicine 医学-医学:内科
CiteScore
6.50
自引率
3.20%
发文量
187
审稿时长
3 months
期刊介绍: Pain Medicine is a multi-disciplinary journal dedicated to pain clinicians, educators and researchers with an interest in pain from various medical specialties such as pain medicine, anaesthesiology, family practice, internal medicine, neurology, neurological surgery, orthopaedic spine surgery, psychiatry, and rehabilitation medicine as well as related health disciplines such as psychology, neuroscience, nursing, nurse practitioner, physical therapy, and integrative health.
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