The standard of clinical practice for most conditions varies from country to country and this is certainly the case for Complex Regional Pain Syndrome (CRPS). Indeed, in Europe there has long been a desire to see a uniformity in approach to the diagnosis, treatment and management of the condition.
With that in mind, this week saw the publication of a paper, “Standards for the diagnosis and management of Complex Regional Pain Syndrome: results of a European Pain Federation task force”. The task force was formed from some of the leading clinical researchers across the continent including, from the UK, Dr Andreas Goebel of the University of Liverpool. They were challenged to “produce mandatory quality standards worded as grammatically imperative (must‐do) statements.” In other words, to be as clear and unambiguous as possible.
Have they succeeded?
What they claim to have produced is “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.”
Of these 17 standards, there are 4 in pain management, 3 each for physical rehabilitation and care pathways, 2 each for diagnosis and distress management and 1 each for assessment, multi-disciplinary care and information/education.
Of course, these very much represent minimum standards. Despite that, very few countries meet them already. For the majority, the timescale for implementation is likely to be a lengthy one.
Agreement was not possible in all areas and they also concede that “research [is] needed to improve the validity and uptake of these standards”. However, at the very least they represent for the first time a benchmark for healthcare organisations at a national level.
In the UK, in 2018 the Royal College of Physicians published their own new and detailed guidelines on the diagnosis and management of CRPS.