Streamlining Care for Patients With Compression Neuropathies: The Carpal Tunnel Plus Pathway (CTS+ Pathway)

The goal of this clinical trial is to assess the impact of a new care pathway (the Carpal Tunnel Plus Pathway) in patients with carpal tunnel syndrome. The main questions it aims to answer are:

1. What was the effect of the Carpal Tunnel Plus Pathway on wait times between each step of the care pathway (e.g. from referral to initial consult, from initial consult to surgical consult, etc.)?
2. How satisfied are patients with the care they received through the Carpal Tunnel Plus Pathway?

Researchers will compare wait times pre- and post- Pathway implementation to see if there was any change.

Participants will be asked to complete a short patient satisfaction survey.

Study Overview

• Status: Enrolling by invitation
• Conditions: Carpal Tunnel Syndrome (CTS)
• Intervention / Treatment: Procedure: Changes to the care pathway for carpal tunnel syndrome (The Carpal Tunnel Plus Pathway)

• Study Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V5Z 1M9
      • Vancouver General Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Retrospective: Patients age 18 or over seen by study surgeons for CTS. Prospective: patients age 18 or over with carpal tunnel syndrome seen at SPH or Vancouver Hospital EMG lab.

Description

Inclusion Criteria:

• 18 years of age or older
• Referred to the Vancouver General Hospital Neuromuscular Disease Unit or St. Paul's Hospital with a confirmed diagnosis of carpal tunnel syndrome
• Ability to understand English

Exclusion Criteria:

• Inability to provide informed consent

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Retrospective (Pre-Intervention); Participants in this arm were treated for carpal tunnel syndrome before the Carpal Tunnel Plus Pathway was implemented.
Prospective (Post-Intervention); Participants in this arm were treated for carpal tunnel syndrome after the Carpal Tunnel Plus Pathway was implemented.	Procedure: Changes to the care pathway for carpal tunnel syndrome (The Carpal Tunnel Plus Pathway); Changes to the care pathway for carpal tunnel syndrome. Features of the CTS+ pathway include new referral form, care map for mild, moderate and severe CTS established, point or care ultrasound with steroid injection introduced, and expedited referral to surgeons.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Wait times	Time between each step of the care pathway (e.g. from referral to EMG/neurologic consultation, from referral to surgical consultation, from surgical consultation to surgery)	From initial referral to surgery/injection (variable, but approximately 9 months)
Patient satisfaction	Patients will be asked to complete a short questionnaire to indicate their level of satisfaction with the care that they received. The custom survey will consist of 4 questions on various aspects of their care that participants will rate on a scale of 1-5 (1 = not at all satisfied, 5 = very satisfied).	Immediately after surgery/injection appointment

Collaborators and Investigators

• Sponsor: University of British Columbia
• Investigators: Principal Investigator: Kristine Chapman, University of British Columbia

Publications and helpful links

Helpful Links

• Website for the Carpal Tunnel Plus Pathway

Study record dates

Study Major Dates

• Study Start (Actual): February 18, 2025
• Primary Completion (Estimated): March 1, 2026
• Study Completion (Estimated): March 1, 2026

Study Registration Dates

• First Submitted: December 2, 2024
• First Submitted That Met QC Criteria: December 2, 2024
• First Posted (Actual): December 5, 2024

Study Record Updates

• Last Update Posted (Actual): December 26, 2025
• Last Update Submitted That Met QC Criteria: December 18, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Carpal Tunnel Syndrome; Patient Satisfaction; Care Pathway
• Additional Relevant MeSH Terms: Nervous System Diseases; Wounds and Injuries; Neuromuscular Diseases; Peripheral Nervous System Diseases; Median Neuropathy; Mononeuropathies; Nerve Compression Syndromes; Cumulative Trauma Disorders; Sprains and Strains; Behavior; Treatment Adherence and Compliance; Health Behavior; Carpal Tunnel Syndrome; Patient Satisfaction
• Other Study ID Numbers: H24-03066

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared. Only group averages/summary measures will be included in any publications.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No