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Eur J Pain. 2019 Apr;23(4):641-651. doi: 10.1002/ejp.1362. Epub 2019 Feb 18.

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

Author information

1
Walton Centre NHS Foundation Trust, Liverpool, UK.
2
Pain Research Institute, University of Liverpool, Liverpool, UK.
3
Department of Neurology, University of Mainz, Mainz, Germany.
4
Physical Medicine and Rheumatology, Balgrist University Hospital, Zurich, Switzerland.
5
Pain Rehabilitation Unit, Habilita Hospitals, Zingonia di Ciserano, Italy.
6
Centre for Pain Research, The University of Bath, Bath, Uk.
7
Department of Clinical and Health Psychology, Ghent University, Ghent, Belgium.
8
European Pain Federation, Brussels, Belgium.
9
Rambam Health Care Campus, Institute of Pain Medicine, Haifa, Israel.
10
Florence Nightingale Foundation Clinical Professor of Nursing, University of West of England, Bristol & Royal United Hospitals NHS Foundation Trust, Bath, UK.
11
Sansom Institute, University of South Australia, Adelade, Australia.
12
Department of Anaesthesiology, VU University Medical Center, Amsterdam, Netherlands.
13
Pain Center, Cochin Hospital, Paris Descartes University, Paris, France.
14
Danish Pain Research Center and Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
15
Patiëntenvereniging CRPS, Nijmegen, The Netherlands.
16
Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland.

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.

PMID:
30620109
PMCID:
PMC6593444
DOI:
10.1002/ejp.1362
[Indexed for MEDLINE]
Free PMC Article

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