Effectiveness of a multimodal inpatient treatment for pediatric chronic pain: a comparison between children and adolescents.
OBJECTIVE
To evaluate short and long-term treatment outcome of children (7-10 years) in comparison to adolescents (11-18 years) with disabling chronic pain following multimodal inpatient pain treatment.


METHODS
Thirty-three children and 167 adolescents underwent multimodal inpatient pain treatment. Standardized assessment of pain-related variables, disability, coping, and use of analgesics was performed at admission, 3- and 12-month follow-up.


RESULTS
Children and adolescents displayed similar pain-characteristics at admission. Adolescents demonstrated significantly higher disability and passive pain coping. Children relied more on others when in pain. All core variables (i.e., pain intensity, pain-related disability, school absence and pain-related coping) decreased significantly in both children and adolescents after 3 months. Both groups maintained this decline 12 months later. More than half of the children and adolescents demonstrated a 50%-reduction in pain intensity after 3 months, and almost 60% after 12 months. Use of analgesics was significantly reduced at 3-month follow-up with no additional changes after 12 months. While age did not exert any impact on results, there were significant gender differences in pain intensity and school absence. Girls demonstrated higher pain intensity and higher school absence 1 year following treatment.


CONCLUSIONS
Children display similar pain-characteristics to adolescents when entering inpatient treatment. A multimodal inpatient program appears to stop the the long-term vicious cycle of disability and pain for both children and adolescents. The demonstrated gender differences raise issues for further research and the possibility of additional pain management strategies for girls.
Vodafone Foundation Institute for Children's Pain Therapy and Paediatric Palliative Care, Clinic for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany. T.Hechler@kinderklinik-datteln.de
Tanja
T
Hechler
Markus
M
Blankenburg
Michael
M
Dobe
Joachim
J
Kosfelder
Bettina
B
Hübner
Boris
B
Zernikow
D000223:Adaptation, Psychological; D000293:Adolescent; D000367:Age Factors; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D018710:Pain Clinics; D059408:Pain Management; D010147:Pain Measurement; D010348:Patient Care Team; D012574:Schools; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000700:Analgesics