Persistent pain is a global health care issue affecting more than 30% of children and young people. mHealth applications delivered using smartphones, are an innovative method to engage children in pain self-management. This article outlines the evidence concerning the development, implementation, and evaluation of mHealth apps for these children in terms of feasibility, acceptability, and impact on important pain outcomes such as quality of life and health care utilization.

No abstract

Aim: Tonsillectomy procedures are a core element of paediatrics; however, perioperative management differs. This study aimed to describe tonsillectomy management, including the burden of pain, nausea and delayed recovery. Methods: A prospective cohort study was undertaken through an audit of tonsillectomy perioperative practice and recovery and survey interviews with family members 7-14 days post-surgery. The study was undertaken at an Australian tertiary referral paediatric hospital between June and September 2016. Results: The audit included 255 children undergoing tonsillectomy, with 127 family members interviewed. Most participants underwent adenotonsillectomy (n = 216; 85%), with a primary diagnosis of obstructive sleep apnoea (n = 205; 80%) and a mean age of 7 years (standard deviation; 3.9). A variety of intra-operative pain relief and antiemetics was administered. Pain was present in 29% (n = 26) of participants at ward return, increasing to 32-45% at 4-20 h and decreasing to 21% (n = 15) at discharge. A third of the children (32%; n = 41) had moderate to severe pain at post-discharge interview, and 30% (n = 38) experienced nausea at home. Most parents (82%; n = 104) were still giving regular paracetamol at 7 days post-operatively, and 31% (n = 39) had finished their oxycodone. Of the participants, 14% (n = 26) presented to the emergency department within 7 days of discharge; 8% (n = 20) of the total cohort were re-admitted. Conclusions: There was variety in perioperative and post-discharge care. Pain scores were infrequently documented post-tonsillectomy, and parents are generally dissatisfied with the management of post-operative pain and nausea. Further research is needed to provide a more consistent approach to perioperative management to promote recovery.What is already known on this topic 1 Tonsillectomy is a commonly performed procedure in children. 2 Significant risk of morbidity and delays to recovery continue to exist. 3 Post-operative pain, nausea and vomiting, bleeding and infection remain problematic, contributing to re-presentation to emergency departments and readmission rates. What this paper adds1 Pain scores are infrequently documented post-tonsillectomy. 2 Parents are generally dissatisfied with the management of postoperative pain and nausea, and the majority of our participants sought additional information from either their local pharmacy or general practitioner post-discharge. 3 Enhanced parental pre-operative education focusing on pain management may benefit children's outcomes.Tonsillectomy, with and without adenoidectomy, is a frequently performed surgical procedure for children world-wide. 1,2 Tonsillectomies are mainly performed for the treatment of adenotonsillar hypertrophy (resulting in sleep-disordered breathing) and recurrent tonsillitis. 1,3 However, despite its safe reputation, tonsillectomies are associated with significant risk of morbidity and delays to recovery. 2,4,5 Post-operative complications include bleeding, respiratory compromise, infection, dehydration, pain,...