Health-Related Quality of Life and Factors Predicting Impairment After Intensive Interdisciplinary Pain Treatment
Mayank Seth1, Katherine Bentley2, Pritha Dalal3
1Research Department, Children's Specialized Hospital Long Term Care Center, Mountainside, NJ; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ.
Insights
Intensive interdisciplinary pain treatment (IIPT) significantly improved health-related quality of life (HRQoL) in children with chronic pain. Lower admission scores and more diagnoses predicted poorer HRQoL at discharge.
Area of Science:
- Pediatric Pain Management
- Rehabilitation Medicine
- Quality of Life Research
Background:
- Chronic pain affects a significant number of children, impacting their overall well-being and daily functioning.
- Intensive interdisciplinary pain treatment (IIPT) offers a comprehensive approach to managing complex pediatric pain conditions.
Purpose of the Study:
- To evaluate changes in health-related quality of life (HRQoL) among children with chronic pain following a 4-week inpatient IIPT program.
- To identify predictors of impaired HRQoL at the time of discharge from the IIPT program.
Main Methods:
- A secondary analysis of data from 269 children (mean age 16±3 years, 79% girls) admitted to two inpatient IIPT programs.
- Utilized the Pediatric Quality of Life Inventory Short Form (PedsQL-SF) and Numerical Pain Rating Scale at admission and discharge.
- Employed a 4-week intensive interdisciplinary program including physical therapy, occupational therapy, cognitive behavioral therapy, aqua therapy, and mindfulness.
Main Results:
- Patients demonstrated significant improvements in mean PedsQL-SF scores from admission to discharge (average increase of 21 points, p<.001).
- All HRQoL subdomains, including physical, emotional, social, and school functioning, showed significant gains.
- Lower PedsQL-SF scores at admission and a higher number of pain diagnoses were significantly associated with impaired HRQoL at discharge.
Conclusions:
- Participation in IIPT is associated with meaningful improvements in HRQoL for pediatric patients with chronic pain.
- Identifying risk factors for impaired HRQoL can aid in tailoring treatments and determining the need for post-treatment support.
Objective:
To examine changes in health-related quality of life (HRQoL) in children with chronic pain after intensive interdisciplinary pain treatment (IIPT), and to identify risk factors for impaired HRQoL at discharge.
Design:
Multicenter (n=2) secondary analysis study.
Setting:
Inpatient acute rehabilitation.
Participants:
Children with chronic pain (N=269, mean age ± SD=16±3y, 79% girls) admitted to one of two 4-week inpatient IIPT programs between November 2017 and February 2025.
Interventions:
All patients participated in a 4-week IIPT program (average length of stay). The program aimed to improve physical function, reduce catastrophic thinking, and promote healthy habits through an interdisciplinary approach. Treatment included individual and group sessions in physical and occupational therapy, cognitive behavioral therapy, aqua therapy, and mindfulness, with a focus on endurance, strength, desensitization, and coping strategies.
Main Outcome Measures:
At admission and discharge from IIPT, patients completed the Pediatric Quality of Life Inventory Short Form (PedsQL-SF) and rated their pain intensity using a Numerical Pain Rating Scale.
Results:
Patients reported significant improvements in mean PedsQL-SF scores (p<.001), with an average increase of 21 points from admission to discharge. Additionally, significant gains were also observed across all subdomains: physical, emotional, social, and school functioning. Impaired HRQoL at discharge was significantly associated with lower PedsQL-SF scores at admission and the number of pain diagnoses.
Conclusions:
Participation in IIPT may lead to meaningful improvements in HRQoL for children with chronic pain. Moreover, factors associated with impaired HRQoL may help tailor treatment and identify children who may benefit from continued support post-IIPT.
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