Effective Spinal Cord Stimulation Does Not Improve Caregiver Burden in Patients With Chronic Neuropathic Pain. Results of the CARESTIM-Study

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-09-05 DOI:10.1002/ejp.70122

Robin M. Bouttelgier, Stijn Vandamme, Bart Billet, Barbara Declercq, Karel Hanssens, Werner Nagels, Amaury Verhamme, Jan Dossche, Olivier De Coster, Nick De Naeyer, Ruben De Vos, Wim Maenhoudt, Jeroen Van Lerbeirghe, Olivier Van Damme, Stephanie Du Four, Dimitri Vanhauwaert

{"title":"Effective Spinal Cord Stimulation Does Not Improve Caregiver Burden in Patients With Chronic Neuropathic Pain. Results of the CARESTIM-Study","authors":"Robin M. Bouttelgier, Stijn Vandamme, Bart Billet, Barbara Declercq, Karel Hanssens, Werner Nagels, Amaury Verhamme, Jan Dossche, Olivier De Coster, Nick De Naeyer, Ruben De Vos, Wim Maenhoudt, Jeroen Van Lerbeirghe, Olivier Van Damme, Stephanie Du Four, Dimitri Vanhauwaert","doi":"10.1002/ejp.70122","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic and ischaemic pain. Although patient-reported outcomes have increasingly gained recognition, the impact of SCS on informal caregivers—an equally important consideration—remains underexplored. This study aims to address this gap by evaluating multidimensional outcomes following SCS, with a particular focus on the burden experienced by informal caregivers over a one-year period.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A prospective cohort study was conducted involving 35 patient-caregiver dyads treated with SCS between January and December 2021 at AZ Delta and Jan Yperman Hospital. Inclusion required the availability of a spousal or offspring caregiver. Patients and caregivers were evaluated preoperatively and at 3, 6 and 12 months postoperatively using validated instruments including the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQuality of Life-5 Dimensions (EQ5D), Zarit Burden Index (ZBI), Modified Caregiver Strain Index (MCSI) and Relation Quality Indexes (RQI).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Patients reported significant reductions in leg and back pain (<i>p</i> < 0.001), leading to decreased disability (<i>p</i> < 0.001) and improved quality of life (<i>p</i> < 0.05) during follow-up. However, no significant changes were observed in caregiver burden or in the quality of the patient-caregiver relationship.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>While patients reported significantly lower pain and better quality of life following SCS, these benefits do not extend to reducing caregiver burden or strengthening the patient-caregiver relationship. A holistic treatment approach that actively involves caregivers may be necessary to optimise outcomes for both patients and caregivers. Further research with a larger cohort is required.</p>\n </section>\n \n <section>\n \n <h3> Significance Statement</h3>\n \n <p>This prospective cohort study is the first to analyze the patient-caregiver dyad in chronic pain patients treated with SCS. Although SCS effectively reduces pain and improves the quality of life of patients, these benefits do not extend to reducing caregiver burden or enhancing the patient-caregiver relationship. We argue that a more holistic approach, including caregiver involvement in the treatment process, may be necessary to improve outcomes for both patients and caregivers.</p>\n </section>\n </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":"29 9","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Pain","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ejp.70122","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Spinal cord stimulation (SCS) is a well-established treatment for chronic neuropathic and ischaemic pain. Although patient-reported outcomes have increasingly gained recognition, the impact of SCS on informal caregivers—an equally important consideration—remains underexplored. This study aims to address this gap by evaluating multidimensional outcomes following SCS, with a particular focus on the burden experienced by informal caregivers over a one-year period.

Methods

A prospective cohort study was conducted involving 35 patient-caregiver dyads treated with SCS between January and December 2021 at AZ Delta and Jan Yperman Hospital. Inclusion required the availability of a spousal or offspring caregiver. Patients and caregivers were evaluated preoperatively and at 3, 6 and 12 months postoperatively using validated instruments including the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQuality of Life-5 Dimensions (EQ5D), Zarit Burden Index (ZBI), Modified Caregiver Strain Index (MCSI) and Relation Quality Indexes (RQI).

Results

Patients reported significant reductions in leg and back pain (p < 0.001), leading to decreased disability (p < 0.001) and improved quality of life (p < 0.05) during follow-up. However, no significant changes were observed in caregiver burden or in the quality of the patient-caregiver relationship.

Conclusions

While patients reported significantly lower pain and better quality of life following SCS, these benefits do not extend to reducing caregiver burden or strengthening the patient-caregiver relationship. A holistic treatment approach that actively involves caregivers may be necessary to optimise outcomes for both patients and caregivers. Further research with a larger cohort is required.

Significance Statement

This prospective cohort study is the first to analyze the patient-caregiver dyad in chronic pain patients treated with SCS. Although SCS effectively reduces pain and improves the quality of life of patients, these benefits do not extend to reducing caregiver burden or enhancing the patient-caregiver relationship. We argue that a more holistic approach, including caregiver involvement in the treatment process, may be necessary to improve outcomes for both patients and caregivers.

查看原文本刊更多论文

有效的脊髓刺激不能改善慢性神经性疼痛患者的照顾者负担。carestim研究的结果

脊髓刺激（SCS）是一种公认的治疗慢性神经性和缺血性疼痛的方法。尽管患者报告的结果越来越得到认可，但SCS对非正式护理人员的影响——一个同样重要的考虑因素——仍未得到充分探讨。本研究旨在通过评估SCS后的多维结果来解决这一差距，特别关注非正式护理人员在一年内所经历的负担。方法前瞻性队列研究纳入了2021年1月至12月在AZ Delta和Jan Yperman医院接受SCS治疗的35对患者-护理者。纳入要求有配偶或子女照顾者。术前、术后3、6、12个月采用经验证的工具对患者和护理人员进行评估，包括数字评定量表（NRS）、Oswestry残疾指数（ODI）、欧洲生活质量5维度（EQ5D）、Zarit负担指数（ZBI）、改良护理人员压力指数（MCSI）和关系质量指数（RQI）。结果随访期间，患者腿部和背部疼痛明显减轻（p < 0.001），导致残疾减少（p < 0.001），生活质量提高（p < 0.05）。然而，在照顾者负担或病人-照顾者关系的质量方面没有观察到显著的变化。结论：虽然患者报告SCS后疼痛明显减轻，生活质量更好，但这些益处并没有延伸到减轻照顾者负担或加强病人-照顾者关系。积极涉及护理人员的整体治疗方法可能是必要的，以优化患者和护理人员的结果。需要对更大的队列进行进一步的研究。这项前瞻性队列研究首次分析了接受SCS治疗的慢性疼痛患者的患者-护理者二元关系。虽然SCS有效地减轻了患者的疼痛，提高了患者的生活质量，但这些好处并没有延伸到减轻照顾者的负担或加强病人与照顾者的关系。我们认为，一种更全面的方法，包括护理人员参与治疗过程，可能是必要的，以改善患者和护理人员的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.