• Pain Med · Jan 2018

    Randomized Controlled Trial Observational Study

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

    • Boris Zernikow, Ann-Kristin Ruhe, Lorin Stahlschmidt, Pia Schmidt, Tobias Staratzke, Michael Frosch, and Julia Wager.
    • Department of Children's Pain Therapy and Paediatric Palliative Care, German Paediatric Pain Centre, Children's and Adolescents' Hospital Datteln, Witten/Herdecke University, Faculty of Health, School of Medicine, Witten, Germany.
    • Pain Med. 2018 Jan 1; 19 (1): 16-28.

    ObjectiveDisabling pediatric chronic pain is accompanied by a significant burden to those affected and by high societal costs. Furthermore, it bears the risk of aggravation into adulthood. Studies have shown intensive interdisciplinary pain treatment to result in short-term positive effects on pain-related and psychological outcomes. In this study, we aimed to prove the stability of the long-term effects of intensive interdisciplinary pain treatment four years after treatment.MethodsThis longitudinal observational study followed adolescents who had received intensive interdisciplinary pain treatment over four years. We defined a combined end point, overall improvement (pain intensity, pain-related disability, and school/work absence), and investigated three additional psychological outcome domains (anxiety, depression, pain catastrophizing). We also examined changes to economic parameters (health care utilization, subjective financial burden) and their relationship to patient improvement.ResultsSimilar patterns were observed for pain-related and psychological outcome domains, with data showing statistically and clinically significant reductions from admission to four-year follow-up. These positive effects were stable from one- to four-year follow-up. Approximately 60% of the adolescents showed an overall long-term improvement. Older age was found to be a risk factor for treatment failure. Economic parameters decreased statistically significantly, particularly for those with an overall improvement of the chronic pain disorder.ConclusionsThe results of this study support the long-term effectiveness of intensive interdisciplinary pain treatment and indicate that it can interrupt pain chronification. Future research is warranted to investigate why some of the adolescents did not show improvement and to allow for a more individualized treatment.© 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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