TY - JOUR
T1 - Patient selection for spinal cord stimulation
T2 - The importance of an integrated assessment of clinical and psychosocial factors
AU - Thomson, Simon
AU - Helsen, Nicky
AU - Prangnell, Simon
AU - Paroli, Mery
AU - Baranidharan, Ganesan
AU - Belaïd, Hayat
AU - Billet, Bart
AU - Eldabe, Sam
AU - de Carolis, Giuliano
AU - Demartini, Laura
AU - Gatzinsky, Kliment
AU - Kallewaard, Jan Willem
AU - Winkelmüller, Matthias
AU - Huygen, Frank
AU - Stoevelaar, Herman
N1 - Funding Information: This study was funded by Boston Scientific. The funder was not involved in the design, set‐up and conduct of this study, nor the preparation of this manuscript. The manuscript has been shared with the funder after submission. Funding Information: All experts, except Hayat Belaïd and Giuliano De Carolis, were financially compensated by Ismar Healthcare with funds from Boston Scientific for their contribution to the study. Nicky Helsen and Herman Stoevelaar received institutional fees from Boston Scientific for advice to the design of the study and data analysis. Additional disclosures outside the submitted work: Frank Huygen reports personal fees from Abbott, Saluda, Salvia, Pfizer, Grunenthal and Boston Scientific; Simon Thomson reports personal fees from Boston Scientific; Simon Prangnell reports personal fees from Boston Scientific; Ganesan Baranidharan reports grants and personal fees from Abbott, Boston Scientific and Nevro as well as personal fees from Nalu Medical and Stryker; Bart Billet reports personal fees from Nevro, Salvia Bioelectronics and Abbott; Sam Eldabe reports grants and personal fees from Medtronic and Boston Scientific and personal fees from Mainstay Medical and Riemser Pharma; Giuliano de Carolis is the president of Peder Dolore‐SICD, Italy; Laura Demartini reports personal fees from Boston Scientific and Abbott; Kliment Gatzinsky received consulting fees from Boston Scientific and Medtronic, honoraria from Abbott, Boston Scientific and Nevro and participated in advisory boards of Boston Scientific and Medtronic; Jan Willem Kallewaard received research grants from Abbott, Boston Scientific and Nevro and participated in advisory boards of Abbott, Boston Scientific, Medtronic, Nevro and Saluda; Matthias Winkelmüller reports personal fees from Boston Scientific. Publisher Copyright: © 2022 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC ®.
PY - 2022/10
Y1 - 2022/10
N2 - Background: A previously developed educational e-health tool considers both clinical and psychosocial factors when selecting patients with chronic pain for spinal cord stimulation (SCS). The validity of the composite recommendations was evaluated in a retrospective study, demonstrating a strong relationship with patient outcomes after SCS. Methods: An additional retrospective analysis was performed to determine the added value of a psychosocial evaluation as part of the decision-making process on SCS. Data concerned 482 patients who were considered for SCS in 2018–2019. The analysis focused on the relationship between the different layers of the tool recommendations (clinical, psychosocial, composite) with trial results and patient outcomes at 6 months after SCS. Of the initial study population, 381 patients underwent SCS and had follow-up data on at least one of three pain-related outcome measures. Results: Pain improvement was observed in 76% of the patients for whom SCS was strongly recommended based on merely the clinical aspects. This percentage varied by the level of psychosocial problems and ranged from 86% in patients without any compromising psychosocial factors to 60% in those with severe problems. Similarly, the severity of psychosocial problems affected trial results in patients for whom SCS was either recommended or strongly recommended. Conclusions: The strong relationship between psychosocial factors embedded in the SCS e-health tool and patient outcomes supports an integrated and multidisciplinary approach in the selection of patients for SCS. The educational e-health tool, combining both clinical and psychosocial aspects, is believed to be helpful for further education and implementation of this approach. Significance statement: This study confirms the relevance of the psychosocial factors embedded in the educational SCS e-health tool (https://scstool.org/). The strong relationship between the severity of psychosocial factors with patient outcomes supports conducting a comprehensive psychological and behavioural assessment when determining the eligibility of patients for SCS.
AB - Background: A previously developed educational e-health tool considers both clinical and psychosocial factors when selecting patients with chronic pain for spinal cord stimulation (SCS). The validity of the composite recommendations was evaluated in a retrospective study, demonstrating a strong relationship with patient outcomes after SCS. Methods: An additional retrospective analysis was performed to determine the added value of a psychosocial evaluation as part of the decision-making process on SCS. Data concerned 482 patients who were considered for SCS in 2018–2019. The analysis focused on the relationship between the different layers of the tool recommendations (clinical, psychosocial, composite) with trial results and patient outcomes at 6 months after SCS. Of the initial study population, 381 patients underwent SCS and had follow-up data on at least one of three pain-related outcome measures. Results: Pain improvement was observed in 76% of the patients for whom SCS was strongly recommended based on merely the clinical aspects. This percentage varied by the level of psychosocial problems and ranged from 86% in patients without any compromising psychosocial factors to 60% in those with severe problems. Similarly, the severity of psychosocial problems affected trial results in patients for whom SCS was either recommended or strongly recommended. Conclusions: The strong relationship between psychosocial factors embedded in the SCS e-health tool and patient outcomes supports an integrated and multidisciplinary approach in the selection of patients for SCS. The educational e-health tool, combining both clinical and psychosocial aspects, is believed to be helpful for further education and implementation of this approach. Significance statement: This study confirms the relevance of the psychosocial factors embedded in the educational SCS e-health tool (https://scstool.org/). The strong relationship between the severity of psychosocial factors with patient outcomes supports conducting a comprehensive psychological and behavioural assessment when determining the eligibility of patients for SCS.
UR - http://www.scopus.com/inward/record.url?scp=85135462537&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ejp.2009
DO - https://doi.org/10.1002/ejp.2009
M3 - Article
C2 - 35856311
SN - 1090-3801
VL - 26
SP - 1873
EP - 1881
JO - European journal of pain (London, England)
JF - European journal of pain (London, England)
IS - 9
ER -