title: Trends in Medicalization of Children with Amplified Musculoskeletal Pain Syndrome.
abstract: The objective of this survey was to describe trends over time in medicalization of children with Amplified Musculoskeletal Pain Syndrome (AMPS).
  
  
  
  A retrospective evaluation was conducted using self-reported data from patients presenting to the pain clinic between January 1, 2008 and December 31, 2014, who were diagnosed with AMPS.
  
  
  
  This was a medical record review of 899 subjects ages 3-20 presenting with Amplified Musculoskeletal Pain Syndrome. Subjects were included if they presented to a single tertiary specialized clinic and obtained a diagnosis of AMPS between January 1, 2008 and December 31, 2014.
  
  
  
  Information collected from subjects' medical records included: past medications, current outpatient medications, procedures, aids, therapies, studies, professionals seen, hospitalizations, and surgeries. Trends in medicalization were analyzed by year of initial visit.
  
  
  
  Medication use, procedures, studies, therapies, professionals seen, hospitalizations, and surgeries in children with AMPS all increased significantly by year ( P  < 0.001). The degree of physical dysfunction, pain, and the use of aids did not significantly increase.
  
  
  
  Children with amplified musculoskeletal pain syndrome are becoming increasingly medicalized. Increased medicalization introduces risk of iatrogenic injury and burdens families with unnecessary medical costs. The significant increase in medicalization of children with AMPS is not related to an increase in patient reported pain, which is evidenced by the lack of significant increase in patients' pain score, pain duration, or functional disability at the time of their initial evaluation.
authors: Division of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
authors: Elizabeth L
authors: EL
authors: Kaufman
authors: Division of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
authors: Jenna
authors: J
authors: Tress
authors: Division of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
authors: David D
authors: DD
authors: Sherry
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000600:supply & distribution*; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D000069342:Medical Overuse / Q000706:statistics & numerical data*; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D010147:Pain Measurement / Q000187:drug effects / Q000706:statistics & numerical data; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: Child; Chronic Pain; Complex Regional Pain Syndrome; Fibromyalgia; Health Utilization; Medicalization; Medication Overuse