Bruce Barbara K, Ale Chelsea M, Harrison Tracy E, Bee Susan, Luedtke Connie, Geske Jennifer, Weiss Karen E
Departments of *Psychiatry & Psychology, Mayo Clinic Pediatric Pain Rehabilitation Center ‡Anesthesiology §Nursing ∥Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN †Department of Psychiatry & Psychology, Mayo Clinic, Jacksonville, FL.
Clin J Pain. 2017 Jun;33(6):535-542. doi: 10.1097/AJP.0000000000000433.
This study examined key functional outcomes following a 3-week interdisciplinary pediatric pain rehabilitation program for adolescents with chronic pain. Maintenance of gains was evaluated at 3-month follow-up.
Participants included 171 adolescents (12 to 18 y of age) with chronic pain who completed a hospital-based outpatient pediatric pain rehabilitation program. Participants completed measures of functional disability, depressive symptoms, pain catastrophizing, opioid use, school attendance, and pain severity at admission, discharge, and at 3-month follow-up.
Similar to other interdisciplinary pediatric pain rehabilitation program outcome studies, significant improvements were observed at the end of the program. These improvements appeared to be maintained or further improved at 3-month follow-up. Nearly 14% of the patients were taking daily opioid medication at admission to the program. All adolescents were completely tapered off of these medications at the end of the 3-week program and remained abstinent at 3-month follow-up.
This study adds to the available data supporting interdisciplinary pediatric pain rehabilitation as effective in improving functioning and psychological distress even when discontinuing opioids. Implications for future research and limitations of the study are discussed.
本研究调查了针对慢性疼痛青少年的为期3周的跨学科儿科疼痛康复项目后的关键功能结局。在3个月的随访中评估了改善情况的维持情况。
参与者包括171名患有慢性疼痛的青少年(12至18岁),他们完成了一个以医院为基础的门诊儿科疼痛康复项目。参与者在入院、出院时以及3个月随访时完成了功能残疾、抑郁症状、疼痛灾难化、阿片类药物使用、上学出勤率和疼痛严重程度的测量。
与其他跨学科儿科疼痛康复项目结局研究相似,在项目结束时观察到了显著改善。这些改善在3个月随访时似乎得以维持或进一步改善。近14%的患者在项目入院时每日服用阿片类药物。在为期3周的项目结束时,所有青少年都完全停用了这些药物,并且在3个月随访时仍未使用。
本研究补充了现有数据,支持跨学科儿科疼痛康复即使在停用阿片类药物时也能有效改善功能和心理困扰。讨论了对未来研究的启示和本研究的局限性。