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Social deprivation and paediatric chronic pain referrals in Ireland: a cross-sectional study
Eveline Matthews1, Maeve Muldoon2, Norma O'Keeffe2
1Children's Health Ireland at Crumlin, Dublin, Ireland.
Insights
Social deprivation did not affect paediatric chronic pain referrals in Ireland. However, disadvantaged children experienced longer pain duration, poorer sleep, and parents reported higher pain catastrophizing.
Area of Science:
- Pediatric Chronic Pain Research
- Social Determinants of Health
- Pain Management
Background:
- Social deprivation is linked to increased pediatric chronic pain prevalence.
- Children from disadvantaged backgrounds are underrepresented in specialist pain programs.
- Understanding referral patterns and characteristics is crucial for equitable care.
Purpose of the Study:
- To investigate the relationship between social deprivation and pediatric chronic pain referrals in Ireland.
- To analyze differences in pain characteristics and function between deprivation groups.
- To identify potential disparities in care for socially disadvantaged children.
Main Methods:
- Retrospective review of 288 patient records from a national pediatric complex pain service (February 2016 - November 2019).
- Assessment of social deprivation using the Pobal HP Deprivation Index.
- Analysis of pain characteristics, parental pain catastrophizing, and pain-related disability via questionnaires.
Main Results:
- Pediatric chronic pain referrals were normally distributed across deprivation grades.
- Children in disadvantaged groups reported longer pain duration, increased screen time at bedtime, and longer sleep onset latency.
- Parents in disadvantaged groups exhibited significantly higher levels of pain catastrophizing.
Conclusions:
- While referral rates were similar, socially disadvantaged children with chronic pain present with distinct characteristics.
- Further research is needed to understand the longitudinal impact of social factors on pain chronicity.
- Targeted interventions may be necessary to improve treatment outcomes for children from disadvantaged backgrounds.
Objectives:
Social deprivation is associated with a higher prevalence of chronic pain in children and an under-representation in specialist paediatric chronic pain programs. Our primary objective was to determine if there was a relationship between social deprivation and paediatric chronic pain referrals in Ireland. Secondary objectives included analysing for differences between deprivation groups in pain characteristics and function that are recorded at first clinic visit.
Methods:
Families attending the national paediatric complex pain service in Dublin, Ireland, complete questionnaires on pain characteristics, parental pain catastrophizing, and pain-related disability including sleep quality and school attendance. We retrospectively reviewed records from between February 2016 and November 2019 on 288 patients. Social deprivation was assessed using the Pobal HP Deprivation Index, which is based on data from the Irish national census.
Results:
Referrals followed a normal distribution across deprivation grades. Children in the disadvantaged group had a longer duration of pain, greater use of screens at bedtime, and longer sleep onset latency. Parents in the disadvantaged group had significantly higher levels of parental pain catastrophizing.
Conclusions:
In Ireland, while paediatric chronic pain referrals were normally distributed across deprivation group, the disadvantaged group was different in several ways that may be clinically significant. Further work will be needed to determine the longitudinal relationship between these factors before and after the referral and initial review. Screening for, and targeting, potential risk factors for pain chronicity may be needed to harmonize treatment outcomes in children from socially disadvantaged families.
