Patterns of patient outcomes following specialist pain management in Australasia: a latent class analysis using the electronic Persistent Pain Outcomes Collaboration database

Tardif, Hilarie; Allingham, Samuel F; Rahman, M. Dalil; Daly, Anne

doi:10.1097/j.pain.0000000000002799

Cited by 3 publications

(3 citation statements)

References 53 publications

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“…A prior publication 75 has demonstrated that families attending pediatric pain services contributing to the PaedePPOC database commonly reside in areas of socioeconomic advantage. Future research could examine the role of socioeconomic disadvantage, income tiers, education level, and geographic and financial access to services in relation to caregiver burden.…”

Section: Discussionmentioning

confidence: 99%

“…The current study documented widespread effects of pediatric chronic pain on caregivers in multiple domains of psychosocial and work functioning, highlighting the need for increased clinical attention to the well-being of caregivers, particularly given the complex interactions between caregiver and child wellbeing. 1,14 A prior publication 75 has demonstrated that families attending pediatric pain services contributing to the Pae-dePPOC database commonly reside in areas of socioeconomic advantage. Future research could examine the role of socioeconomic disadvantage, income tiers, education level, and geographic and financial access to services in relation to caregiver burden.…”

Section: Clinical and Research Directionsmentioning

confidence: 99%

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Caregiver Burden Associated with Pediatric Chronic Pain

Ngo,

Palmer,

Gorrie

et al. 2023

The Clinical Journal of Pain

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Objectives: This retrospective, cross-sectional study investigated the nature and extent of burden experienced by caregivers of adolescents and children with chronic pain, and factors associated with increased caregiver burden. Methods: The Paediatric electronic Persistent Pain Outcomes Collaboration (PaedePPOC) database provided prospectively collected data from 1,929 families attending 9 pediatric chronic pain services across Australia and New Zealand. Data included demographic information, responses to child pain and functioning measures, caregiver work impairment and psychosocial functioning. Results: Caregivers of pediatric chronic pain patients reported work impairment associated with their child’s pain (mean 15%±SD 25 absenteeism; 38%±SD 29 productivity lost), significantly worse than published international population norms (large-scale community survey data), most other caregiver samples of adults and children with other chronic conditions, and adult samples with various pain conditions. Caregivers reported considerable burden in multiple psychosocial functioning domains, particularly leisure functioning, pain-related catastrophizing, and adverse parenting behaviors (with greater pain-related avoidance). Caregiver psychosocial burden was significantly associated with child psychosocial functioning (β=−0.308, P<0.01), school absenteeism (β=0.161, P<0.01), physical disability (β=0.096, P<0.05) and pain duration (β=0.084, P<0.05), but not pain intensity. Caregiver work productivity lost was significantly associated with school absenteeism (β=0.290, P<0.01), child physical disability (β=0.148, P<0.01), child healthcare utilization (β=0.118, P<0.05) and worst pain intensity (β=0.101, P<0.05). Discussion: These results highlight the significant and varied impacts experienced by caregivers of children with chronic pain. This work is novel in reporting significant work impairment and confirms psychosocial burden in a larger sample than previous studies.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical and Research Directionsmentioning

confidence: 99%

Caregiver Burden Associated with Pediatric Chronic Pain

Ngo,

Palmer,

Gorrie

et al. 2023

The Clinical Journal of Pain

View full text Add to dashboard Cite

show abstract

“…In 1990, Denis Turk reviewed studies assessing whether it was possible to identify patterns of patient responses, and if this was the case, to use this information for tailoring treatment to different subgroups. 19 In the current issue of PAIN, Tardif et al 17 continue and advance this quest. They based their findings on a large cohort of adult patients (n 5 23,915) who completed extensive evaluation and treatment in 75 specialist pain services in Australia and New Zealand.…”

mentioning

confidence: 99%

Insights from studying a large cohort of patients

Zaslansky

Meißner

Stamer

2022

Pain

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Characterizing phenotypes and clinical and health utilization associations of young people with chronic pain: latent class analysis using the electronic Persistent Pain Outcomes Collaboration database

Slater,

Waller,

Briggs

et al. 2024

Pain

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Using the Australiasian electronic Persistent Pain Outcomes Collaboration, a binational pain registry collecting standardized clinical data from paediatric ePPOC (PaedsePPOC) and adult pain services (AdultePPOC), we explored and characterized nationally representative chronic pain phenotypes and associations with clinical and sociodemographic factors, health care utilization, and medicine use of young people. Young people ≥15.0 and <25.0 years captured in PaedePPOC and AdultePPOC Australian data registry were included. Data from 68 adult and 12 paediatric pain services for a 5-year period January 2018 to December 2022 (first episode, including treatment information) were analysed. Unsupervised latent class analysis was applied to explore the existence of distinct pain phenotypes, with separate models for both services. A 3-phenotype model was selected from both paediatric and adult ePPOC data, with 693 and 3518 young people included, respectively (at least one valid indicator variable). Indicator variables for paediatric models were as follows: pain severity, functional disability (quasisurrogate “pain interference”), pain count, pain duration, pain-related worry (quasisurrogate “catastrophizing”), and emotional functioning; and, for adult models: pain severity, pain interference, pain catastrophizing, emotional functioning, and pain self-efficacy. From both services, 3 similar phenotypes emerged (“low,” “moderate,” “high”), characterized by an increasing symptom-severity gradient in multidimensional pain-related variables, showing meaningful differences across clinical and sociodemographic factors, health service utilization, and medicines use. Derived phenotypes point to the need for novel care models that differentially respond to the needs of distinct groups of young people, providing timely, targeted, age-appropriate care. To effectively scale such care, digital technologies can be leveraged to augment phenotype-informed clinical care.

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Patterns of patient outcomes following specialist pain management in Australasia: a latent class analysis using the electronic Persistent Pain Outcomes Collaboration database

Abstract: Supplemental Digital Content is Available in the Text.Patient-reported treatment outcomes across 75 specialist persistent pain services show that approximately one-third of patients report a very positive overall outcome while a further third report little benefit.

Cited by 3 publications

References 53 publications

Caregiver Burden Associated with Pediatric Chronic Pain

Caregiver Burden Associated with Pediatric Chronic Pain

Insights from studying a large cohort of patients

Characterizing phenotypes and clinical and health utilization associations of young people with chronic pain: latent class analysis using the electronic Persistent Pain Outcomes Collaboration database

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