Clinical and Economic Long-Term Treatment Outcome of Children and Adolescents with Disabling Chronic Pain

Zernikow, Boris; Ruhe, Ann‐Kristin; Stahlschmidt, Lorin; Schmidt, P; Staratzke, Tobias; Frosch, Michael; Wager, Julia

doi:10.1093/pm/pnx067

Cited by 48 publications

(58 citation statements)

References 24 publications

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“…It is of utmost importance to introduce comprehensive pain care early in the pediatric age group to optimize patients' QOL now and in the future. 349…”

Section: Unique Issues Related To Pediatric Pain Managementmentioning

confidence: 99%

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

Darnall¹,

Krishnamurthy²,

Tsuei³

et al. 2020

JMIR Form Res

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Background Patients with chronic pain often have limited access to comprehensive care that includes behavioral pain management strategies. Virtual reality (VR) is an immersive technology and emerging digital behavioral pain therapy with analgesic efficacy for acute pain. We found no scientific literature on skills-based VR behavioral programs for chronic pain populations. Objective The primary aim of this study is to evaluate the feasibility of a self-administered VR program that included content and skills informed by evidence-based behavioral treatment for chronic pain. The secondary aim is to determine the preliminary efficacy of the VR program in terms of average pain intensity and pain-related interference with activity, stress, mood, and sleep, and its impact on pain-related cognition and self-efficacy. The tertiary aim was to conduct a randomized controlled trial (RCT) and compare the VR treatment with an audio-only treatment. This comparison isolated the immersive effects of the VR program, thereby informing potential mechanisms of effect. Methods We conducted an RCT involving a web-based convenience sample of adults (N=97) aged 18-75 years with self-reported chronic nonmalignant low back pain or fibromyalgia, with an average pain intensity >4 over the past month and chronic pain duration >6 months. Enrolled participants were randomly assigned to 1 of 2 unblinded treatments: (1) VR: a 21-day, skills-based VR program for chronic pain; and (2) audio: an audio-only version of the 21-day VR program. The analytic data set included participants who completed at least 1 of 8 surveys administered during the intervention period: VR (n=39) and audio (n=35). Results The VR and audio groups launched a total of 1067 and 1048 sessions, respectively. The majority of VR participants (n=19/25, 76%) reported no nausea or motion sickness. High satisfaction ratings were reported for VR (n=24/29, 83%) and audio (n=26/33, 72%). For VR efficacy, symptom improvement over time was found for each pain variable (all P<.001), with results strengthening after 2 weeks. Importantly, significant time×group effects were found in favor of the VR group for average pain intensity (P=.04), pain-related inference with activity (P=.005), sleep (P<.001), mood (P<.001), and stress (P=.003). For pain catastrophizing and pain self-efficacy, we found a significant declining trend for both treatment groups. Conclusions High engagement and satisfaction combined with low levels of adverse effects support the feasibility and acceptability of at-home skills-based VR for chronic pain. A significant reduction in pain outcomes over the course of the 21-day treatment both within the VR group and compared with an audio-only version suggests that VR has the potential to provide enhanced treatment and greater improvement across a range of pain outcomes. These findings provide a foundation for future research on VR behavioral interventions for chronic pain.

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“…It is of utmost importance to introduce comprehensive pain care early in the pediatric age group to optimize patients' QOL now and in the future. 349…”

Section: Unique Issues Related To Pediatric Pain Managementmentioning

confidence: 99%

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

Darnall¹,

Krishnamurthy²,

Tsuei³

et al. 2020

JMIR Form Res

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“…Other LTx programs may use these data to guide chronic pain management in their cohorts and consider similar multidisciplinary approaches or intensive inpatient therapy to improve transplant‐related outcomes while minimizing long‐term opioid use. Recent studies have shown that not only have these methods been more effective in treating pain while limiting the use of opioids, but they can also reduce costs associated with pain management . For patients with chronic pain, current recommendations emphasize trying other types of prescription pain medication before initiating opioid therapy .…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown that not only have these methods been more effective in treating pain while limiting the use of opioids, but they can also reduce costs associated with pain management. [37][38][39][40][41] For patients with chronic pain, current recommendations emphasize trying other types of prescription pain medication before initiating opioid therapy. 20 More research is needed to determine the long-term safety and efficacy of opioid-sparing approaches to chronic pain in the LTx population.…”

Section: Discussionmentioning

confidence: 99%

Chronic opioid use and clinical outcomes in lung transplant recipients: A single‐center cohort study

Drees

Tumin

Miller

et al. 2018

Clinical Respiratory J

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“…B. durch Arbeitsausfall der Eltern, aber auch Kosten für die Familien (Fahrten, Therapiekosten etc.) [8,9]. Auf lange Sicht lässt sich sehr schwer abschätzen, welche Kosten entstehen, wenn die Betroffenen evtl.…”

Section: Folgen Chronischer Schmerzenunclassified

Chronischer Schmerz bei Kindern und Jugendlichen

Ahnert¹

2020

Zeitschrift für Komplementärmedizin

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SummaryChronischer Schmerz bei Kindern und Jugendlichen ist ein unterschätztes Thema. Die Prävalenz ist in den letzten Jahrzehnten gestiegen. Von großer Bedeutung ist nicht nur die Stärke des Schmerzes, sondern die gefühlte Beeinträchtigung durch den Schmerz. Entscheidend für das Ausmaß des Leidens sind schmerzbezogene Überzeugungen, Resilienzfaktoren und das damit verbundene Verhalten und Einschränkungen. Diese betreffen häufig das Vermeiden von Sozialkontakten, aber auch das Auftreten weiterer Beschwerden wie Schlafstörungen, Appetitverlust, Konzentrationsschwierigkeiten, die weitreichende Folgen haben können für die weitere Entwicklung in allen Bereichen des Lebens. In der Therapie ist immer eine individuelle Betrachtung des jeweiligen Falles notwendig.Zur Behandlung bei Kindern und Jugendlichen hat sich die multimodale Schmerztherapie als wirksam erwiesen. Die Autorin stellt anhand dreier Fälle aus der Praxis die Komplexität des chronischen Schmerzes vor sowie das Vorgehen in der multimodalen Schmerztherapie.

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Clinical and Economic Long-Term Treatment Outcome of Children and Adolescents with Disabling Chronic Pain

Cited by 48 publications

References 24 publications

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study

Chronic opioid use and clinical outcomes in lung transplant recipients: A single‐center cohort study

Chronischer Schmerz bei Kindern und Jugendlichen

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