To propose a new interdisciplinary model for managing the polytrauma clinical triad (PCT) as a complex chronic pain syndrome, addressing the significant challenges faced by US Service Members and Veterans.
Approach:
FREIDEM Model: The Functional Recovery Enabling Inter-Disciplinary Evaluation and Management (FREIDEM) model conceptualizes PCT as a complex chronic pain syndrome influenced by PTSD, TBI, and other comorbidities, integrating recent clinical advances in treatment.
Key Findings:
PCT is prevalent among US Service Members and Veterans, with about 13% meeting diagnostic criteria.
Current management strategies are fragmented and often fail to address the complex needs of PCT patients.
Many patients show improvement within 5 years, but a significant number experience worsening symptoms despite care.
Interpretation:
The FREIDEM model aims to integrate clinical advances in treating complex chronic pain syndromes and emphasizes the need for a comprehensive treatment plan addressing biopsychosocial impediments.
Limitations:
Further research is needed to validate the effectiveness of the FREIDEM model in improving outcomes for patients with PCT.
Existing care models are often fragmented and lack a unified approach for managing the complexities of PCT.
Conclusion:
The FREIDEM model provides a framework for treating PCT as a complex chronic pain syndrome.
Older patients with documented cognitive impairment also experienced greater postoperative functional decline following elective total knee arthroplasty
