Pain in Children and Adults with Cystic Fibrosis: A Comparative Study

Abstract

Pain is a potential complication of cystic fibrosis (CF), but its consequences in daily life and other issues of pain management are not yet clearly understood. We undertook a comparative study of children and adults with CF to assess the prevalence of pain symptoms, their characteristics and treatment, their impact on daily quality of life, and the occurrence of procedural pain. The study included 73 children (1-18 years) and 110 adults (18-52 years); 59% of the children and 89% of the adults reported at least one episode of pain during the previous month. Pain was significantly more intense and lasted significantly longer among adults, but its rate and recurrence did not differ significantly between the two populations and were not related to the severity of CF. The most prevalent locations were the abdomen for children, and the back, head, and chest for adults. Although pain significantly limited physical activity, only 15% of patients reported that it caused absenteeism, and 27% reported that it negatively affected their family life. The mean pain intensity rates on a visual analog scale for the episode that had caused the greatest pain during the past month were 4.9 (2) (mean [SD]) for children and 6 (2) for adults; however, only 40% and 50%, respectively, of those with pain reported the use of analgesic treatment, mainly paracetamol (acetaminophen). At least one episode of procedural pain during the previous month was reported by 85% of children and 78% of adults. Our study demonstrates the high incidence of undertreated pain in CF patients throughout their lives.

Chronological Age and Risk of Chemotherapy Nonfeasibility:

“…27 Our data on the number of cycles received were also similar to those from randomized controlled trials, 21,28 although patients older than 70 years contributed <10% of the population in these trials compared with 30% in our study. Our study is the first assessment of RDI in CRC patients receiving a homogeneous adjuvant chemotherapy regimen in the real-life setting.…”

Evaluation of selected insomnia predictors in adolescents and young adults with cystic fibrosis

“…Our study showed in subgroup of patients with pain a link between the quality of sleep and the intensity of pain 34,35 , whose location was heterogeneous. As in the study conducted by Lechtzin et al 36 , the abdomen and head/sinuses were the sources of pain most often indicated by patients.…”

Recurrent abdominal pain in children with cystic fibrosis: A pilot prospective longitudinal evaluation of characteristics and management

“…Pain characteristics did not differ according to age or gender in that study [5] conversely to the Perquin report [14] which found more prevalent chronic pain in females and in patients over 12 years of age. In a recent survey of pain in CF patients throughout their lives, Sermet-Gaudelus et al [6] outlined a high incidence of untreated pain; they studied 73 children and 59% reported at least one episode of pain during the previous month, with prevalent abdominal location (60%) and mean pain intensity on the FPS-R of 4.9; 15% reported school absenteeism and one-third of the cohort reported a negative impact on their family life. Contrary to the study done by Koh et al [5], the authors emphasised that CF children experienced intense, longlasting and recurrent pain episodes.…”

“…Cystic fibrosis (CF) children commonly experience abdominal pain whatever the severity of disease [5,6] but such studies must be interpreted with caution since patients were asked to report pain experienced over a period of time without longitudinal pain assessment; moreover gastrointestinal investigations aimed at assessing pain aetiology were missing. Thus, we conducted a prospective cross-sectional study using Apley's criteria to define recurrent abdominal pain (RAP): "at least three bouts of pain, severe enough to affect activities, over a period of not less than 3 months, with attacks in the year preceding the examination" [7].…”