Long‐term outcomes of children with severe chronic pain: Comparison of former patients with a community sample

Abstract

Background Findings on the short‐ and long‐term effectiveness of intensive interdisciplinary pain treatment (IIPT) for children with severe chronic functional pain are promising. However, a definitive appraisal of long‐term effectiveness cannot be made due to a lack of comparison groups. The aim of the present study was to compare the health status of former patients with the health status of an age‐ and sex‐matched comparison group from the community. Methods Data from two samples, a clinical sample of former patients (n = 162; aged 14 to 26) and an age‐ and sex‐matched community sample (n = 162), were analysed. Former patients provided data 7 years after IIPT. Pain characteristics, physical and mental health status, autonomy, coping and health care utilisation were compared between the two samples. Results Seven years after treatment, the majority (58%) of the clinical sample were completely pain‐free. Compared to the community sample, the clinical sample demonstrated worse physical and mental health and continued to seek more frequent health care, irrespective of whether or not they experienced ongoing chronic pain. However, the clinical sample reported better coping strategies and a comparable level of autonomy. Conclusion Patients experiencing severe chronic pain in childhood who engage in IIPT are likely to have recovered from their pain in early adulthood. Long‐term treatment effects may manifest in better coping strategies. However, reduced mental and physical health status may indicate a negative long‐term effect of early chronic pain experiences or a general vulnerability in people developing a chronic pain condition in childhood. Significance The majority of severely impaired paediatric chronic pain patients no longer suffer from chronic pain seven years after intensive interdisciplinary pain treatment. However, former patients have worse physical and mental health status than a community sample, and continue to seek out more frequent health care utilisation, irrespective of whether or not they continue to experience chronic pain. Therefore, potential negative long‐term effects of childhood chronic pain experiences need specific attention early on.

Baseline Factors Associated with Pain Intensity, Pain Catastrophizing, and Pain Interference in Intensive Interdisciplinary Pain Treatment for Youth

“…However, it is also possible that gender is not associated with IIPT outcomes for other reasons-previous research on the same cohort in a broader sample including multi-modal therapy found that gender was not associated with pain interference during treatment [54]. While a previous systematic review on children and adolescents (ages [5][6][7][8][9][10][11][12][13][14][15][16][17][18] showed that girls experience more chronic pain than boys [1], another systematic review on young adults (aged [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] showed an equal prevalence of chronic pain between sexes [55]. Additional research is therefore needed to clarify gender differences in adolescents with chronic pain.…”

“…Recent systematic reviews show significant reductions in mean pain intensity and disability at discharge and 2-24 month followup [6,7]. Longer-term studies suggest that these improvements may be retained for several years after treatment [12][13][14]. Parents experience direct benefits from IIPT as well, with improvements in their own depression and anxiety symptoms, pain catastrophizing, and parenting behaviour [15].…”

Chronic pain-related consultations to the emergency department of children with complex pain conditions: A retrospective analysis of healthcare utilization and costs

“…Though many of the previous studies demonstrated a decrease in health care utilization and costs following interdisciplinary chronic pain management services, a study by Wager et al demonstrated that though pediatric patients with chronic pain treated with intensive inpatient chronic pain management had a high likelihood of recovering from their chronic pain condition by adulthood, they continued to display increased health care utilization irrespective of whether they were still experiencing chronic pain or not. 19 This highlights that pediatric patients with chronic pain are likely to experience increased healthcare utilization even several years following management of their pain, thus contributing to high healthcare costs.…”

Terapi Musik sebagai Terapi Nonfarmakologi terhadap Respon Fisiologis dan Intensitas Nyeri pada Anak di Ruang Rawat Intensif: Telaah Sistematis

“…Nyeri yang tidak ditangani dengan baik dapat memberikan dampak penurunan status kesehatan fisik dan mental (Wager et al, 2021). Perubahan respon fisiologis dapat terjadi akibat nyeri yang tidak ditangani dengan baik.…”