The following is a summary of “Effect of an interdisciplinary inpatient program for patients with CRPS in reducing disease activity –a single center prospective cohort study,” published in the March 2024 issue of Pain by Schneider et al.

Researchers conducted a retrospective study to assess whether inpatient treatment improves disease activity in CRPS patients without further outpatient options and to identify factors associated with such improvement.

They assessed the primary outcome, disease severity (measured by CRPS Severity Score, ranging from 0 to 16 points). Secondary outcomes, including depression, anxiety, physical function, pain interference, fatigue, sleep disturbance, and ability to participate in social roles and activities, were evaluated using the Promis-29. According to international guidelines, the study examined pain-related factors and patient feedback, with assessments at discharge and follow-ups at three and six months. Baseline variables associated with CRPS severity were determined using mixed-effects models.

The results showed that 25 patients completed the program, with a mean age of 49.28 (SD 11.23) years, and 92% females, with a mean symptom duration of 8.5 (SD 6.5) months. A significant reduction in disease activity (CSS -2.36, P<0.0001), pain (PROMIS-29 pain -0.88, P=0.005), and emotional function (PROMIS-29 depression -5.05, P<0.001; fatigue -4.63, P=0.002) from baseline to discharge. Moderate evidence of reduction was observed for pain interference (+2.27, P=0.05), social participation (PROMIS-29 +1.93, P=0.05), anxiety (PROMIS-29 -3.32, P=0.02), and physical function (PROMIS-29 +1.3, P=0.03) at discharge. Upon discharge, 92% of patients (23 of 25) reported overall improvement. Medication intake decreased at 3 months (MQS -8.22, P=0.002) and 6 months (MQS -8.69, P=0.001) follow-up. Enhanced social participation at 3 months (PROMIS-29 +1.72, P=0.03) and improved sleep at 6 months (PROMIS-29 +2.38, P=0.008). Mixed models demonstrated that baseline pain patients had lower disease activity.

Investigators concluded that inpatient interdisciplinary treatment improved CRPS activity, pain, physical function, emotional well-being, and social participation, with most benefits persisting up to six months after discharge.

Source: academic.oup.com/painmedicine/advance-article/doi/10.1093/pm/pnae021/7635166