Complex regional pain syndrome: Facilitating the use of self-management strategies

André E Bussières,Julie Turbide,June Litowski,Léonie Duranleau,Marie-Pier Durivage,Rosalie Blais-Hébert,Xuan Chi Julia Dao

doi:10.5348/d05-2017-30-oa-6

André E Bussières, Julie Turbide + Show 5 more

Open Access

https://doi.org/10.5348/d05-2017-30-oa-6

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Abstract

Aims: While several interventions are used to treat complex regional pain syndrome (CRPS), patient adherence to recommended care including self-management is challenging. To understand the barriers and facilitators to using self-management strategies among CRPS patients; to explore educational tools used to enable self-management; and to develop knowledge translation interventions to address potential barriers using intervention mapping. Methods: Semi-structured interviews of patients were conducted to identify the determinants of self-management. Findings informed the development of a tailored theory-based intervention to increase adherence. Result: Theoretical domains identified were: Social influence, Beliefs about capabilities, Beliefs about consequences, Environmental context and resources. Various educational tools were provided by treating clinicians. Interventions should consider increasing knowledge about treatment outcomes, identifying health antecedents and promoting self-monitoring. Conclusion: Online educational interventions focusing on patient advice, self-monitoring, and techniques to increase the quality of the clinician-patient relationship may successfully address patient barriers to using self-management strategies.

Highlights

Complex regional pain syndrome (CRPS) is an uncommon neuropathic pain disorder that can develop after trauma, surgery, and occasionally occurs spontaneously
While the differentiating factor is the presence of a known nerve injury in CRPSII, the treatments are often similar for both subtypes [4]
Six participants were referred by the Constance-Lethbridge Rehabilitation Centre (CLRC) and four participants were referred by a member of the CRPS community of practice (CoP) from the Hôtel-Dieu de Lévis

Summary

Introduction

Complex regional pain syndrome (CRPS) is an uncommon neuropathic pain disorder that can develop after trauma, surgery, and occasionally occurs spontaneously. Studies in the United States and the Netherlands indicate that CRPS is an orphan disease since less than 200,00 people are affected each year [1]. CRPS can be divided into two subtypes: CRPSI and CRPSII. While CRPS symptoms subside within 6–13 months for most people, 15–20% will develop long-term disabilities [1]. A standardized core measurement set (core outcome measurement set for complex regional pain syndrome clinical studies) was recently developed to capture the multidimensional nature of CRPS [1]. CRPS has various clinical presentations in which persistent pain in combination with varying maladaptive responses in the sympathetic-mediated vasomotor control, peripheral, and central neuronal plasticity are affected [4]. Perhaps due to the wide range of the clinical presentation, the overall quality of supporting therapeutic evidence is low [4]

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