Health Care Utilization Following Cognitive-Behavioral Therapy for Pediatric Abdominal Pain: A Randomized Clinical...

The current study assessed health care utilization (HCU) by pediatric patients with functional abdominal pain disorder (FAPD) and compared rates of HCU between youth who received cognitive-behavioral therapy (CBT) as part of a randomized clinical trial and those who received medical treatment as usual (TAU).

Participants between the ages of 9 to 14 were randomly assigned to receive either CBT (n=39) or TAU (n=39). Participants in the active arm received the Aim to Decrease Anxiety and Pain Treatment (ADAPT), an evidence-based CBT intervention targeting abdominal pain and mental health symptoms. The frequency of HCU 12 months postintervention was examined using objective data via the electronic medical record (EMR). HCU variables included outpatient gastroenterology (GI) clinic visits, outpatient psychology/psychiatry visits, Emergency Department visits, and hospitalizations. Count regression models tested the effect of ADAPT on HCU.

In the total sample, HCU of subspecialty and emergency treatment services was overall low. ADAPT participants may have had fewer GI clinic visits (IRR=0.86, CI=0.45-1.68), psychology/psychiatry visits (IRR=0.84, CI=0.10-6.88), and hospitalizations (IRR=0.37, CI=0.04-3.68) than TAU participants, though wide confidence intervals were noted.

Findings suggest variation in HCU between youth with FAPD who received CBT and those who received TAU. More work is needed to examine how cognitive-behavioral interventions may impact HCU in pediatric patients with FAPD and related Disorders of Gut-Brain Interaction.