title: Chronic pain among children and adolescents: physician consultation and medication use.
abstract: OBJECTIVE
  The goal of this study was to assess physician consultation and use of medication in Dutch children and adolescents (0-18 years old) having chronic pain in relation to sociodemographic factors and pain characteristics.
  
  
  METHODS
  This was a population-based cross-sectional survey. A questionnaire was either mailed to the participants' parents or distributed at school, and it was filled out by the parents (for children aged 0-7 years) or by the participant (for children and adolescents aged 8-18 years).
  
  
  METHODS
  The study was conducted in the Rotterdam area.
  
  
  METHODS
  Participants included a random sample of 1,300 children aged 0 to 3 years taken from the register of population. In addition, 41 schools were selected to obtain a representative sample of 5,336 children and adolescents aged 4 to 18 years.
  
  
  METHODS
  Reported physician consultation and medication use were assessed.
  
  
  RESULTS
  Of the 6,636 children and adolescents surveyed, 5,424 (82%) responded. A total of 1,358 respondents (25%) reported chronic pain. Of these, 57% had consulted a physician and 39% had used medication for the pain. Respondents with earache, more intense pain, and more frequent pain and those attending lower vocational training programs were more likely to consult a physician for the pain than the average respondent. Respondents with earache, sore throat, headache, more intense pain, and multiple pain; children aged 0 to 3 years; and girls were more likely to use medication for the pain. Logistic regression analyses showed that for physician consultation, the most significant predictive factors were the intensity of pain, age, and earache as well as the level of education for respondents aged 12 to 16 years. The use of medication was predicted by earache, headache, limb pain, intensity of pain, and age.
  
  
  CONCLUSIONS
  Chronic pain is a common complaint in children and adolescents, frequently resulting in consultation of a physician and medication use. Regarding physician consultation, children and adolescents with a lower educational level seem to be a group at risk.
authors.affiliation: Department of General Practice, Erasmus University Rotterdam, The Netherlands. Perquin@hag.fgg.eur.nl
authors.forename: C W
authors.initials: CW
authors.lastname: Perquin
authors.forename: A A
authors.initials: AA
authors.lastname: Hazebroek-Kampschreur
authors.forename: J A
authors.initials: JA
authors.lastname: Hunfeld
authors.forename: L W
authors.initials: LW
authors.lastname: van Suijlekom-Smit
authors.forename: J
authors.initials: J
authors.lastname: Passchier
authors.forename: J C
authors.initials: JC
authors.lastname: van der Wouden
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology*; D059408:Pain Management; D011153:Population; D012017:Referral and Consultation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires