I'm aware of specific pre-habilitation programmes for these devices, but they muddy the waters as they provide information and advice around using the device. I am more interested in the delivery of a generic pain management programme to such patients - is this better done pre or post implantation. In the absence of evidence, what are the various opinions. Thanks.
Hi Martin
Have you asked the NHSGGC Library Network to do a search of the evidence on this topic for you - go to www.quest.scot.nhs.uk, sign up then "support for evidence and searching".
best wishes
Lynn
www.quest.scot.nhs.uk
Hi Martin
I don't know of any evidence in this area but I have significant anecdotal experience in this area. I co-ordinated and worked clinically in an adult group pain management program for over 15 years (I now do the same with kids). All clinicians noted that patients who had been advised that SCS might be an option sometime in the future did not engage well in the program. Group pain programs are very hard work for the participants and if there is "quick fix" option dangled in front of them they will focus on that. This is only human nature and not a reflection on character. How you manage this really depends on the service and individual patients. SCS can be offered to patients only if they fail a group, or if they request SCS it can be done before a program. I think there is a need for specific SCS preparation programs, different to generic group pain management programs. Again I have worked in this area and seen the benefit. These need to be structured differently and have their own challenges. It would be interesting to see some studies in this area. We have tried to get something up and running here in Perth but as always funding is the issue. I think the Sydney Royal North Shore group may have done some work in this area.
Hi Anna,
Thanks for your response, which corresponds well with the direction my own thoughts were taking. Perhaps we should organise a specific pre-hab programme for SCS patients here.
Regards, Martin
I think your programs will be much more effective if you separate them. In our experience, not only do patients who plan to have SCS at a later date not do well on general programs, but they can also negatively influence other participants. We saw this a lot and it arguably led to poor outcomes for other group participants. This frustrated clinicians (who already work in challenging conditions). If you have the numbers to separate your groups I definitely would. My prediction would be you would have better clinical outcomes and happier staff. Good luck with it!
Cheers
Anna
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