Eur J Pain. 2022 Jun 28. doi: 10.1002/ejp.1998. Online ahead of print.
ABSTRACT
BACKGROUND: For pediatric chronic pain patients, intensive interdisciplinary pain treatment (IIPT) is a well-established treatment. The treatment’s short-term effectiveness can be improved by an additive psychosocial aftercare (PAC). However, neither the program’s long-term effectiveness nor the patients in particular need have been investigated yet.
METHODS: This study aimed at determining the long-term effects of PAC and detecting predictors of treatment outcome within a multicenter randomized controlled trial measured at five time points up to twelve months after discharge. At inpatient admission to IIPT, patients (N=419, 14.3 years of age, 72.3% female) were randomly assigned to intervention or control group. After IIPT discharge, the intervention group received PAC, whereas the control group received treatment as usual (TAU). Patient-reported outcomes included pain and emotional characteristics. Clinicians assessed potential psychosocial risk factors and their prognosis of treatment outcome. Statistical analyses included mixed-models and univariable logistic regressions.
RESULTS: Data at the 12-month follow-up (n=288) showed a significant benefit of PAC compared with TAU; the majority (59.0%) of patients in the PAC-group reported no chronic pain compared to 29.2% of TAU-patients (p<.001). Patients with a single parent specifically benefited from PAC compared to TAU. Clinicians were able to make a reliable prognosis of treatment outcome, but did not successfully predict which patients would benefit the most from PAC.
CONCLUSIONS: Study results suggest that PAC is highly effective irrespective of patient characteristics, but particularly for patients with single parents. Its broad implementation could help to improve the long-term outcomes of youth with severely disabling chronic pain.
PMID:35762280 | DOI:10.1002/ejp.1998
