ABSTRACT
Introduction: Bart's Neuromodulation Centre is a center of excellence for research and innovation. In the UK, the NICE 159 guidelines have highlighted the importance of psychological and multidisciplinary assessment to ascertain the suitability of patients for Neuromodulation. The global pandemic of Covid-19 has had far-reaching physical, psychological, and socioeconomic implications. Despite the various limitations of running services during a pandemic, Barts Neuromodulation Centre maintained the importance of multidisciplinary assessment in the selection of patients suitable for this form of therapy. This paper presents psychological wellbeing outcomes of neuromodulation patients during this unprecedented period. Method(s): Data collection was gathered remotely between January 2021 to December 2021.N=178 completed questionnaires. The mean age was 55 years and 63% were female. Data was collected at baseline and in addition, post-implant data was obtained at 1,3,6 and 12 month follow up. As per NHS England outpatient guidance (2020), all data was completed remotely. All collected data was anonymized and data was stored on an encrypted database. Result(s): Results showed a 78% decrease in depression scores from baseline to 2 years+ and a 76% decrease in anxiety scores from baseline to 2 years+. Conclusion(s): The data demonstrates significant improvements in psychological wellbeing as shown in depression and anxiety scores after SCS therapy. Despite the global pandemic, there remains a strong demand for SCS and encouragingly showed significant improvements in psychological wellbeing. It would be useful to explore ways to improve patient compliance and explore broader parameters of outcomes. Disclosure: Angie Alamgir, PHD: None, Serge Nikolic, MD: None, Habib Ellamushi: None, Amin Elyas, FRCS: None, Joanne Lascelles, Clinical nurse specialist: None, Kavita Poply, PHD: None, Sanskriti Sharma: None, Alia Ahmad, MSc: None, Vivek Mehta: NoneCopyright © 2023
ABSTRACT
Introduction: Covid-19 was classed as a global pandemic by the World Health Organization (WHO) in March 2020. This had an overwhelming effect on the National Health Services (NHS) in the United Kingdom resulting in the disruption and subsequent prioritization of the elective recovery services. Despite the various limitations of delivering services during a pandemic, Barts Neuromodulation Centre maintained the importance of multidisciplinary assessment in the selection of patients suitable for this form of therapy. We present the data on our continued activity through pandemic, dependent on the performance feasibility. The aim of this effectiveness project was to evaluate the post SCS outcome data during covid-19 pandemic. Method(s): This was a telephone and in person data collection of patient responses to standardized and validated pain outcome questionnaires following SCS implant performed at St Bartholomew's Hospital, London during January-December 2021. Data was collated from a tertiary Neuromodulation center at Barts Health NHS Trust, UK. Patients completed the questionnaires prior to SCS implant and post implant 1, 3, 6, and 12 month follow- up appointments with our neuromodulation specialists Results: Two hundred and fifteen patients underwent face to face or telephonic consultation during January to December 2021 for the follow ups. Total 178 patients registered their responses with F:M being 63%:37% and the average age 55 years. At each time point, the following number of patients completed: baseline n= 52;1 month n= 27;3 months n=28;6-month n= 21 and 12 months, n= 26. We demonstrate that NRS pain scores reduced by 43%, ODI disability improved by 35%, HADS anxiety reduced by 45%, depression reduced by 46%, PSQ sleep improved by 77% and EQ5D quality of life improved by 66% at 12 months when compared to baseline. There were no serious adverse events reported through this time. Conclusion(s): To our knowledge, this is one of the first reported real-world post SCS outcome data of prospective follow ups. We demonstrate safe delivery of services and data collection feasibility through pandemic. Moreover, our patient cohort showed improvement in the all dimensions of chronic refractory pain following SCS therapy despite clinical burden of COVID-19. Disclosure: Alia Ahmad: None, Angie Alamgir, PHD: None, Sanskriti Sharma: None, Joanne Lascelles, Clinical nurse specialist: None, Amin Elyas, FRCS: None, Helen Bonar: None, Serge Nikolic, MD: None, Habib Ellamushi: None, Vivek Mehta: None, Kavita Poply, PHD: NoneCopyright © 2023
ABSTRACT
Introduction: Bart's Neuromodulation Centre is a centre of excellence for research and innovation. In the UK, the NICE 159 guidelines have highlighted the importance of psychological and multidisciplinary assessment to ascertain the suitability of patients for Neuromodulation. It is widely acknowledged that the global pandemic of Covid-19 has had far-reaching physical, psychological and socioeconomic implications. Despite the various limitations of running services during a pandemic, Barts Neuromodulation Centre maintained the importance of multidisciplinary assessment in the selection of patients suitable for this form of therapy. This paper presents psychological wellbeing outcomes of neuromodulation patients during this unprecedented period. Materials / Methods: Data collection was gathered remotely between January 2021 to December 2021.N=178 completed questionnaires. The mean age was 55 years and 63% were female. Data was collected at baseline and in addition, post-implant data was obtained at 1,3,6 and 12 month follow up. As per NHS England outpatient guidance (2020), all data was completed remotely. All collected data was anonymized and data was stored on an encrypted database. Result(s): Graph 1: HADS Depression Scores [Formula presented] Graph 1 demonstates a 78% decrease in depression scores from baseline to 2 years+ Graph 2: HADS Anxiety Scores [Formula presented] Graph 2 demonstrates a 76% decrease in anxiety scores from baseline to 2 years+. Discussion(s): The data demonstrates significant improvements in psychological wellbeing as shown in depression and anxiety scores after SCS therapy. It would be useful to explore ways to improve patient compliance and explore broader parameters of outcomes. Conclusion(s): Despite the global pandemic, there remains a strong demand for SCS and encouragingly showed significant improvements in psychological wellbeing. Learning Objectives: 1. Evaluate clinical outcomes 2. Understand the impact of a global pandemic on clinical outcomes 3. Delivering remote clinical care and data collection. Keywords: Anxiety, depression, Pain, SCS, neuromodulation, LBP Copyright © 2022
ABSTRACT
Introduction: Bart's Neuromodulation Centre is a centre of excellence for research and innovation. In the UK, the NICE 159 guidelines have highlighted the importance of multidisciplinary assessment to ascertain the suitability of patients for Neuromodulation and prehab in preparation for an SCS procedure. It is widely acknowledged that the global pandemic of Covid-19 has had far-reaching physical, psychological and socioeconomic implications. Despite the various limitations of delivering services during a pandemic, Barts Neuromodulation Centre maintained the importance of multidisciplinary assessment in the selection of patients suitable for this form of therapy. Effective use of video clinics for MDT clinics and remote data collection have been vital in maintaining service delivery. This paper presents a collection of outcomes following neuromodulation intervention during this unprecedented period. Materials / Methods: Data collection was gathered remotely between January 2021 to December 2021.N=178 completed questionnaires. The mean age was 55 years and 63% were female. Data was collected at baseline and in addition, post-implant data was obtained at 1,3,6 and 12 month follow up. As per NHS England outpatient guidance (2020), all data was completed remotely. All collected data was anonymized and data was stored on an encrypted database. Result(s): [Formula presented] Figure 1 shows an overall pain reduction over 12 months. [Formula presented] Figure 2 shows improvements in anxiety and depression scores from HADS. [Formula presented] Figure 3 displays reduction in disability scores. [Formula presented] Figure 4 shows improvements on pain and sleep. [Formula presented] Figure 5 demonstrates improvements in QOL scores. Discussion(s): Despite the Covid-19 pandemic, patients reported welcomed improvements in pain scores, disability, psychological wellbeing, sleep and quality of life. The data suggests a reduction in pain scores by 43%, an improvement in disability by 35%, reduction in anxiety and depression to 45% and 46% respectively, an improvement in sleep by 77% and lastly quality of life by 66%. Conclusion(s): Despite the global pandemic, there remains a strong demand for SCS and encouragingly data showed significant improvements in a range of outcomes. Learning Objectives: 1. Evaluate clinical outcomes 2. Understand the impact of a global pandemic on clinical outcomes 3. Impact of delivering remote clinical care and remote data collection. Keywords: Pain, outcomes, neuromodulation, SCS, COVID-19, LBP Copyright © 2022