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Correlates of complementary and alternative medicine use in a pediatric tertiary pain center
Rachel Vinson1, Gloria Yeh2, Roger B Davis2
1Department of General Pediatrics, Boston Children's Hospital, Boston, Mass.
Insights
Children with chronic pain who use complementary and alternative medicine (CAM) often experience higher pain intensity and disability. However, biobehavioral CAM use correlates with better coping skills.
Area of Science:
- Pediatric Pain Management
- Complementary and Alternative Medicine (CAM)
- Behavioral Health
Background:
- Chronic pain affects a significant pediatric population.
- Complementary and Alternative Medicine (CAM) is increasingly explored for chronic pain management.
- Understanding factors associated with CAM use and its impact on coping is crucial.
Purpose of the Study:
- To identify correlates of CAM use in children with chronic pain.
- To investigate the relationship between CAM use and adaptive coping skills in pediatric chronic pain patients.
Main Methods:
- Analysis of intake data from 1175 pediatric patients (aged 7-18) with chronic pain.
- Utilized validated measures for anxiety, depression, coping skills, and functional disability.
- Employed multivariable logistic and linear regression models to assess CAM use correlates and coping skill associations.
Main Results:
- Female gender, higher parental education, greater pain intensity, and increased functional disability were associated with CAM use.
- Biobehavioral CAM (e.g., relaxation, hypnosis, biofeedback) showed a significant positive correlation with accommodative coping skills (β = 0.2, P = .004).
Conclusions:
- Pediatric patients with chronic pain using CAM tend to report higher pain intensity and functional disability.
- Engagement with biobehavioral CAM techniques is linked to enhanced adaptive coping mechanisms in this population.
Objective:
To examine correlates of complementary and alternative medicine (CAM) use in a pediatric population with chronic pain, and to determine whether CAM use is positively correlated with adaptive coping skills.
Methods:
We examined patient data from 1175 children aged 7 to 18 years with chronic pain who completed the intake assessment at the time of initial evaluation at Boston Children's multidisciplinary Pain Treatment Service between 2003 and 2011. The intake assessment included validated measures of anxiety, depression, pain coping skills, and functional disability. Parents were also asked whether their child had tried CAM modalities in the past. We used a multivariable logistic regression model to determine correlates of CAM use and a multivariable linear regression model to determine the relationship between biobehavioral CAM (relaxation training, hypnosis, and biofeedback) and accommodative coping.
Results:
In our multivariable model, we found that female gender (odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.07-2.02), level of parental education (OR 1.11 per year, 95% CI 1.06-1.16), greater pain intensity (OR 1.06 per point on an 11-point numerical analog scale, 95% CI 1.01-1.11), and more functional disability (OR 1.19 per 10-point increment on the Functional Disability Inventory, 95% CI 1.06-1.34) were independently associated with CAM use. Biobehavioral CAM was found to have a statistically significant correlation with accommodative coping skills (β = 0.2, P = .004).
Conclusions:
In a pediatric chronic pain center, CAM users tended to have higher pain intensity and greater functional disability. Exposure to biobehavioral CAM techniques was associated with adaptive coping skills.
