Using Patient-Recorded Outcome Measures (PROMs) in injectable neurolysis techniques for Morton’s neuroma: a scoping review
Renee Silvester1, Kyber Alam2, Deborah Schoen2 1Bounce Podiatry, Perth, WA, Australia2University of Western Australia, Crawley, WA, Australia
Abstract
Background: Patient-reported outcome measures (PROMs) have increasingly assessed Morton’s neuroma (MN) interventions. Management for MN can involve injectable neurolysis techniques with PROMs helping to assist the timing and improvements of such interventions. This scoping review aimed to map the literature on the types, use and implementation of PROMs for injectable neurolysis techniques for MN.
Methods: The ‘Population, Concept and Context’ framework informed eligibility criteria. Population was defined as those with MN, concept is PROMs within the context of injectable neurolysis techniques. The databases included MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials. Unpublished studies were searched on Google Scholar, ProQuest Theses and Dissertations Global. Duplicates were removed, and full-text articles were reviewed in Covidence against the extraction tool followed by thematic analysis.
Results: Twenty-five articles were included. The interventions included Capsaicin injection, Botulinum Toxin injection, Hyaluronic injection, Phenol injection, Alcohol and Radiofrequency ablation. Over 68% of reported studies utilised the Visual Analogue Scale. The impact of PROMs on the reported interventions included intervention dosage, or frequency, treatment planning or escalation and determining treatment success or failure, although varied significantly between studies.
Conclusions: This scoping review has demonstrated a general discourse of PROMs used in injectable neurolysis techniques for MN research. The types of PROMs primarily applied are continuous pain scales with varied applications and interpretations. This influences treatment, planning, escalation and treatment success. PROMs can play a vital role in the treatment journey for MN and could be used during clinical encounters or to assess intervention response.
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