Are you better? A multi-centre study of patient-defined recovery from Complex Regional Pain Syndrome



Llewellyn, A, McCabe, CS, Hibberd, Y, White, P, Davies, L, Marinus, J, Perez, RGSM, Thomassen, I, Brunner, F, Sontheim, C
et al (show 13 more authors) (2018) Are you better? A multi-centre study of patient-defined recovery from Complex Regional Pain Syndrome. EUROPEAN JOURNAL OF PAIN, 22 (3). pp. 551-564.

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Abstract

<h4>Background</h4>Complex Regional Pain Syndrome (CRPS) symptoms can significantly differ between patients, fluctuate over time, disappear or persist. This leads to problems in defining recovery and in evaluating the efficacy of therapeutic interventions.<h4>Objectives</h4>To define recovery from the patients' perspective and better understand their priorities for treatment approaches.<h4>Methods</h4>Establishing an international consortium, we used a 2-Round Delphi-based study in eight countries across Europe and North America. Participants ≥18 years who met, or had met, Budapest clinical criteria were included. Round 1 participants completed the statement: 'I would/do consider myself recovered from CRPS if/because…' alongside demographic and health questionnaires. Data were thematically organised and represented as 62 statements, from which participants identified and ranked their recovery priorities in Round 2.<h4>Results</h4>Round 1 (N = 347, 80% female, 91% non-recovered) dominant ICF themes were: activities of daily living; bodily functions; external factors; participation and personal factors. The top five priority statements in Round 2 (N = 252) were: no longer having (1) CRPS-related pain, (2) generalised pain and discomfort, (3) restricted range of movement, (4) need for medication, (5) stiffness in the affected limb. With very few exceptions, priorities were consistent, irrespective of patient demographics/geography. Symptoms affecting daily activities were among those most frequently reported.<h4>Conclusions</h4>Our data showed a small number of themes are of highest importance to CRPS patients' definition of recovery. Patients want their pain, movement restriction and reliance on medication to be addressed, above all other factors. These factors should therefore be foremost concerns for future treatment and rehabilitation programmes.<h4>Significance</h4>Those with longstanding CRPS may no longer meet diagnostic criteria but still be symptomatic. Defining recovery is therefore problematic in CRPS. Our study has identified patients' definition of recovery from CRPS, in order of priority, as relief from: their CRPS-related pain, generalised pain, movement restriction, reliance on medication, and stiffness.

Item Type: Article
Uncontrolled Keywords: Extremities, Humans, Complex Regional Pain Syndromes, Analgesics, Pain Measurement, Range of Motion, Articular, Activities of Daily Living, Recovery of Function, Qualitative Research, Delphi Technique, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Europe, Female, Male, Young Adult, Patient Reported Outcome Measures
Depositing User: Symplectic Admin
Date Deposited: 12 Mar 2018 07:57
Last Modified: 19 Jan 2023 06:38
DOI: 10.1002/ejp.1138
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3018829