• Pain · Dec 2022

    Meta Analysis

    Intensive interdisciplinary pain treatment for children and adolescents with chronic non-cancer pain: a preregistered systematic review and individual patient data meta-analysis.

    • Benedikt B Claus, Lorin Stahlschmidt, Emma Dunford, János Major, Cynthia Harbeck-Weber, Rashmi Parekh Bhandari, Ardith Baerveldt, Verena Neß, Kamila Grochowska, Bettina Hübner-Möhler, Boris Zernikow, and Julia Wager.
    • PedScience Research Institute, Datteln, Germany.
    • Pain. 2022 Dec 1; 163 (12): 228123012281-2301.

    AbstractChronic noncancer pain in children and adolescents can be impairing and results in substantial health care costs. Intensive interdisciplinary pain treatment (IIPT), an inpatient or day hospital treatment delivered by a team of 3 or more health professionals, may be an effective intervention for these children and adolescents. Based on previous reviews and meta-analyses, we updated findings regarding the description of available treatments and estimated the effectiveness of IIPT, overcoming methodological shortcomings of previous work by requesting and analyzing individual participant data. On June 26, 2021, we searched 5 literature databases (PubMed, PsycINFO, Web of Science, Cochrane Library, and PubPsych) for studies examining the effectiveness of IIPT. Included studies used a pre-post design, assessed patients younger than 22 years, and presented their results in English, German, French, or Spanish. We used standard methodological procedures expected by Cochrane to pool treatment effects and assess risk of bias. We identified 13 different treatment sites with similar treatment inclusion criteria and treatment components, but the descriptions of those treatments varied widely. Regarding treatment effectiveness, IIPT may result in large improvements in the mean pain intensity ( g = -1.28), disability ( g = -1.91), and number of missed school days at the 12-month follow-up ( g = -0.99), as well as moderate improvements in anxiety ( g = -0.77) and depression ( g = -0.76). The certainty of the evidence, however, was graded from very low to low. We recommend that future researchers use more scientific rigor to increase the certainty of the evidence for IIPT and standardize treatment outcomes for children and adolescents with chronic pain.Copyright © 2022 International Association for the Study of Pain.

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