Chronic pain in children in the UK: a survey of pain clinicians and general practitioners

Bhatia, Anuj; Brennan, Liam; Abrahams, Mark; Gilder, Fay

doi:10.1111/j.1460-9592.2008.02710.x

Cited by 25 publications

(31 citation statements)

References 22 publications

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“…Second, selection bias may have occurred. The response rate was 47% on both occasions, comparable to other survey studies in the field of pediatric anesthesia (34,35). Thirdly, we did not ask questions about the use of opioids in the postoperative period.…”

Section: Discussionsupporting

confidence: 82%

Pain management in intellectually disabled children: a survey of perceptions and current practices among Dutch anesthesiologists

Valkenburg

Kreeft

Leeuw

et al. 2012

Pediatric Anesthesia

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Anesthesiologists in the Netherlands take a different approach when caring for intellectually disabled children and they were not aware of pain observation scales for these children. However, the majority think that intellectually disabled children are not more sensitive to pain or require more analgesia. These opinions did not change over the 4-year period. One way to proceed is to implement validated pain assessment tools and to invest in education.

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Section: Discussionsupporting

confidence: 82%

Pain management in intellectually disabled children: a survey of perceptions and current practices among Dutch anesthesiologists

Valkenburg

Kreeft

Leeuw

et al. 2012

Pediatric Anesthesia

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“…It is well known that chronic pain in children and adolescents is a serious problem with a wide range of consequences on the child’s development [1] and treatment needs to improve [37]. Regrettably, epidemiological data on children with chronic pain in need of specialized treatment does not exist with this study offering a first detailed analysis of children with chronic pain diagnoses requiring specialist intervention.…”

Section: Resultsmentioning

confidence: 99%

“…The prevalence of functional abdominal pain in the community is known to be more common in younger children [35] while prevalence data for migraine in the community suggests an increase with age [36]. Bhatia et al [37] revealed a lack of knowledge of pediatricians and physicians in treating children with chronic pain in primary care which might be specifically prominent in these two groups. This lack of knowledge and earlier referrals to a tertiary pain service for children with more complicated diagnoses could be improved by a comprehensive advanced training program in chronic pain for primary pediatricians.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2249 pediatric pain patients

et al. 2012

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BackgroundPrevalence of pain as a recurrent symptom in children is known to be high, but little is known about children with high impairment from chronic pain seeking specialized treatment. The purpose of this study was the precise description of children with high impairment from chronic pain referred to the German Paediatric Pain Centre over a 5-year period.MethodsDemographic variables, pain characteristics and psychometric measures were assessed at the first evaluation. Subgroup analysis for sex, age and pain location was conducted and multivariate logistic regression applied to identify parameters associated with extremely high impairment.ResultsThe retrospective study consisted of 2249 children assessed at the first evaluation. Tension type headache (48%), migraine (43%) and functional abdominal pain (11%) were the most common diagnoses with a high rate of co-occurrence; 18% had some form of musculoskeletal pain disease. Irrespective of pain location, chronic pain disorder with somatic and psychological factors was diagnosed frequently (43%). 55% of the children suffered from more than one distinct pain diagnosis. Clinically significant depression and general anxiety scores were expressed by 24% and 19% of the patients, respectively. Girls over the age of 13 were more likely to seek tertiary treatment compared to boys. Nearly half of children suffered from daily or constant pain with a mean pain value of 6/10. Extremely high pain-related impairment, operationalized as a comprehensive measure of pain duration, frequency, intensity, pain-related school absence and disability, was associated with older age, multiple locations of pain, increased depression and prior hospital stays. 43% of the children taking analgesics had no indication for pharmacological treatment.ConclusionChildren with chronic pain are a diagnostic and therapeutic challenge as they often have two or more different pain diagnoses, are prone to misuse of analgesics and are severely impaired. They are at increased risk for developmental stagnation. Adequate treatment and referral are essential to interrupt progression of the chronic pain process into adulthood.

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“…1 Increasing numbers of children, however, seem to be presenting both to hospitals and outpatient clinics with complaints of recurrent pain. [2][3][4][5][6][7][8][9][10] Many conditions with an organic etiology such as cancer and sickle cell disease can lead to chronic pain states. However, there are also many patients who present with vague or ill-defined somatic complaints, such as recurrent abdominal pain, which do not correspond with an easily identifiable underlying organic etiology or syndrome.…”

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confidence: 99%

Inpatient Characteristics of the Child Admitted With Chronic Pain

2013

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WHAT'S KNOWN ON THIS SUBJECT: Children with chronic pain complaints seem to represent an increasing portion of general pediatric inpatient services. Few data exist, however, on the characteristics of this population, their length of stay, or the best approach to their evaluation and management. WHAT THIS STUDY ADDS:This study defines the demographic, diagnostic, procedural, and episode of care characteristics for children admitted to the acute care setting with chronic pain syndromes. Admission rates are rising, lengths of stay are substantial, and comorbid diagnoses are common. abstract OBJECTIVE: To define the demographic, diagnostic, procedural, and episode of care characteristics for children admitted with chronic pain. METHODS:We used the Pediatric Health Information System database to obtain data on demographic characteristics, length of stay, readmission rates, diagnoses, and procedures for children admitted with chronic pain. Patients with sickle cell disease, cancer, burns, cerebral palsy, transplants, and ventilator-dependent children were excluded. RESULTS:A total of 3752 patients with chronic pain were identified from 2004 through 2010. Admissions increased by 831% over this time period. The mean age of these patients was 13.5 years, the most common race was white (79%), and female subjects outnumbered male subjects by 2.41 to 1. The most common admission and principal discharge diagnosis was abdominal pain; comorbid diagnoses were common, with a mean of 10 diagnoses per patient. In total, 65% of patients had a comorbid gastrointestinal diagnosis and 44% had a psychiatric diagnosis. The mean length of stay was 7.32 days, with an expected length of stay of 4.24 days; 12.5% were readmitted at least once within 1 year. They underwent a mean of 3.18 procedures per patient. CONCLUSIONS:The average child admitted with chronic pain is a teenaged female with a wide variety of comorbid conditions, many of which are gastrointestinal and psychiatric in nature. Admissions for chronic pain are rising and account for substantial resource utilization. Future studies should further characterize this population, with the overall objective of improving outcomes and optimizing cost-effective care.

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Chronic pain in children in the UK: a survey of pain clinicians and general practitioners

Abstract: More information is required about prevalence, manifestations and long-term effects of chronic pain in children in the UK. There is a need for increasing training and resources amongst GPs and pain clinicians for managing chronic pain in the pediatric age group.

Cited by 25 publications

References 22 publications

Pain management in intellectually disabled children: a survey of perceptions and current practices among Dutch anesthesiologists

Pain management in intellectually disabled children: a survey of perceptions and current practices among Dutch anesthesiologists

Characteristics of highly impaired children with severe chronic pain: a 5-year retrospective study on 2249 pediatric pain patients

Inpatient Characteristics of the Child Admitted With Chronic Pain

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