Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA.
J Pain. 2011 Jul;12(7):747-55. doi: 10.1016/j.jpain.2010.12.011. Epub 2011 Apr 9.
There is limited research describing the patterns of healthcare utilization in adolescents with chronic pain. This study describes healthcare utilization in a clinical chronic pain sample, and compares the patterns of service use of this group to a community sample with intermittent pain complaints. We also investigated demographic and clinical factors that predicted healthcare visits and medication use in the clinical sample. Data on 117 adolescents (aged 12-18; n = 59 clinical pain sample, n = 58 community) were collected. Caregivers and adolescents reported on sociodemographics, medical visits, current medications, pain, activity limitations, and depression. As hypothesized, the clinical pain sample had higher rates of healthcare consultation on all types of medical visits (general, specialty care, complementary medicine, mental health, OT/PT), and higher medication use compared to the community sample. Regression analyses revealed that higher annual income, greater pain frequency, and higher levels of caregiver-reported activity limitations were associated with a greater number of healthcare visits for the total sample. Within the clinical pain sample, higher pain frequency and greater activity limitations (caregiver report) predicted more specialty care visits. Additionally, higher income and greater levels of depressive symptoms predicted a higher number of prescribed medications.
This study contributes to the limited available data on health service and medication use in a clinical chronic pain sample versus a community sample of adolescents. We also identify clinical factors (pain frequency, parent-reported activity limitations, depressive symptoms) and demographic factors (gender, income) associated with healthcare utilization.
关于青少年慢性疼痛患者的医疗保健利用模式，目前的研究还很有限。本研究描述了临床慢性疼痛样本中的医疗保健利用情况，并将该组的服务使用模式与间歇性疼痛投诉的社区样本进行了比较。我们还调查了预测临床样本中医疗保健就诊和药物使用的人口统计学和临床因素。收集了 117 名青少年（年龄 12-18 岁；n = 59 例临床疼痛样本，n = 58 例社区）的数据。照顾者和青少年报告了社会人口统计学资料、医疗就诊、当前用药、疼痛、活动受限和抑郁情况。正如假设的那样，临床疼痛组在所有类型的医疗就诊（一般、专科治疗、补充医学、心理健康、OT/PT）上的医疗咨询率更高，用药率也高于社区组。回归分析显示，较高的年收入、较高的疼痛频率和较高的照顾者报告的活动受限与总样本的更多医疗就诊次数相关。在临床疼痛组中，较高的疼痛频率和较大的活动受限（照顾者报告）预测了更多的专科就诊。此外，较高的收入和较高的抑郁症状水平预测了更多的处方药物。
本研究为临床慢性疼痛样本与青少年社区样本的医疗服务和药物使用的有限可用数据做出了贡献。我们还确定了与医疗保健利用相关的临床因素（疼痛频率、父母报告的活动受限、抑郁症状）和人口统计学因素（性别、收入）。
