title: [Therapy recommendations in a pediatric outpatient pain clinic : Adherence and effectiveness of implementation].
abstract: BACKGROUND
  Supplementary pain-related recommendations for the treatment of chronic pain in children and adolescents are an essential component of multimodal pain treatment. Studies are scarce regarding adherence to these recommendations and their effectiveness.
  
  
  OBJECTIVE
  The aim of this study was to evaluate patient adherence to pain-related recommendations and their effectiveness 12 months after initial presentation of children and adolescents with chronic pain to a pediatric outpatient pain clinic.
  
  
  METHODS
  A total of 413 patients were assessed using a structured telephone interview. The assessment included pain characteristics during the last 4 weeks as well as information regarding the implementation of the pain-related recommendations and the effectiveness. Due to different recommendations given to migraine patients this subgroup was dealt with separately.
  
  
  RESULTS
  Patients reported significant improvements 12 months after the initial presentation and 29.5 % of the patients were pain free. Adherence levels and estimated effectiveness regarding recommendations, such as change of lifestyle, multimodal inpatient treatment and use of medication were high. Other recommendations, such as active relaxation and outpatient psychotherapy had low adherence levels and low estimated effectiveness. Migraine patients had a significantly higher adherence rate and estimated effectiveness regarding the recommendation use of medication than non-migraine patients.
  
  
  CONCLUSIONS
  The adherence level as well as the estimated effectiveness regarding the majority of pain-related recommendations was high. Some recommendations had low adherence rates and low estimated effectiveness. These results can help to further improve the performance of outpatient clinics for children and adolescents with chronic pain.
authors: Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland.
authors: F
authors: F
authors: Barth
authors: Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland. j.wager@deutsches-kinderschmerzzentrum.de.
authors: J
authors: J
authors: Wager
authors: Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland.
authors: B
authors: B
authors: Hübner-Möhler
authors: Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland.
authors: B
authors: B
authors: Zernikow
mesh_terms: D000293:Adolescent; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D002648:Child; D002675:Child, Preschool; D059350:Chronic Pain / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D007407:Interviews as Topic; D008297:Male; D008881:Migraine Disorders / Q000628:therapy; D018710:Pain Clinics / Q000458:organization & administration*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010349:Patient Compliance; D016896:Treatment Outcome; D055815:Young Adult
keywords: Biopsychosocial model; Combined modality therapy; Migraine; Pain management; Telephone interview