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ICD-11 Classification of Pediatric Chronic Pain Referrals in Ireland, with Secondary Analysis of Primary vs Secondary
Eveline Matthews1, Geraldine Murray2, Kevin McCarthy1,2,3
1Children's Health Ireland at Crumlin, Dublin, Ireland.
Insights
This study classified pediatric chronic pain referrals using the International Classification of Diseases 11th version (ICD-11). Chronic primary pain (CPP) and chronic secondary pain (CSP) conditions showed distinct biopsychosocial profiles.
Area of Science:
- Pediatric Pain Medicine
- Clinical Classification Systems
- Biopsychosocial Health
Background:
- Pediatric chronic pain presents a significant clinical challenge.
- Accurate classification is crucial for targeted treatment.
- The International Classification of Diseases 11th version (ICD-11) offers a new framework.
Purpose of the Study:
- To classify pediatric chronic pain referrals in Ireland using the ICD-11.
- To assess differences between chronic primary pain (CPP) and chronic secondary pain (CSP) conditions.
- To evaluate the utility of ICD-11 in pediatric pain management.
Main Methods:
- Retrospective review of 285 pediatric chronic pain assessment forms from Dublin clinics.
- Classification of patients into CPP or CSP based on ICD-11 criteria.
- Secondary analysis of between-group and within-group differences.
Main Results:
- 123 patients had CPP and 162 had CSP; most received multiple parent codes.
- Chronic primary pain (CPP) patients reported higher minimum pain scores than CSP patients.
- Parental pain catastrophizing correlated more strongly with pain intensity and functional interference in the CSP group.
Conclusions:
- The ICD-11 classification system is applicable to pediatric chronic pain.
- Distinct biopsychosocial profiles exist between CPP and CSP in children.
- Further field testing of ICD-11 in pediatric pain is recommended.
Objective:
To classify pediatric chronic pain referrals in Ireland according to the classification system of the 11th version of the International Classification of Diseases (ICD-11). In addition, differences between primary and secondary pain groups were assessed.
Methods:
Retrospective review of complex pain assessment forms completed at the time of initial attendance at pediatric chronic pain clinics in Dublin, Ireland. Patients were classified as having a chronic primary (CPP) or chronic secondary (CSP) pain condition as per ICD-11 classification. Secondary analysis of between-group and within-group differences between primary and secondary pain conditions was undertaken.
Results:
Of 285 patients coded, 123 patients were designated as having a CPP condition (77% of whom were assigned an adjunct parent code) and 162 patients as having a CSP condition (61% of whom were assigned an adjunct parent code). Between-group comparisons found that the lowest reported pain scores were higher in CPP than in CSP conditions. There were stronger correlations between parental pain catastrophizing and pain intensity, school attendance, and pain interference with social activities in the CSP group than in the CPP group.
Conclusions:
The majority of children with both CPP and CSP were assigned multiple parent codes. There appears to be a gradient in the differences in biopsychosocial profile between CPP and CSP conditions. Additional field testing of the ICD-11 classification in pediatric chronic pain will be required.
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