Protocol may ID candidates for neuromodulation therapies for pain

Protocol may ID candidates for neuromodulation therapies for pain

(HealthDay)—A protocol could identify candidates who do not require formal in-person psychological assessment for workup of neuromodulation therapies for pain, according to a study presented at the 20th Annual Pain Medicine Meeting, a meeting of the American Society of Regional Anesthesia and Pain Medicine, held from Nov. 18 to 20 in San Francisco.

Fung Ping Wong, from Toronto Western Hospital, and colleagues compared the outcomes of neuromodulation trials and implants in who bypassed an in-person psychological assessment (fast-track cohort; 57 participants) versus those who had the assessment (114 participants). The fast-track protocol incorporates a short mental health checklist and predefined cutoffs for validated questionnaires, with patients screening positive for unresolved psychological conditions undergoing an in-person psychological assessment.

The researchers found that 72 percent of patients having the psychological assessment and 70 percent in the fast-track group had a successful spinal cord stimulation trial. At six to 12 months following the implant (78 patients with follow-up data), 48.15 percent of patients in the fast-track group and 47.06 percent of patients receiving the psychological had ≥30 percent reduction in scores from preimplant levels.

"An algorithm incorporating predefined thresholds on validated questionnaires and a mental health checklist can be used to identify patients who do not need a formal in-person without a negative impact on outcomes of neuromodulation therapies for pain," the authors write. "This can help reduce wait times and optimize utilization of health care resources."

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