Characteristics of the Pediatric Chronic Pain Service in a Developing Country: A Retrospective Study

This study aimed to describe the need for multidisciplinary management in a pediatric chronic pain service, characteristics of pediatric patients, types of pain management, and outcomes in a tertiary care university hospital in Thailand.

This retrospective study included pediatric patients aged between 0 and 17 years old receiving chronic pain services, both inpatient and outpatient, between August 2021 and December 2023. Demographic data, primary medical diagnosis, pain diagnosis, pain characteristics, psychological diagnosis, multidisciplinary management, and patient outcomes were collected. Pain-related diagnoses were then coded into the 11^th revision of the International Classification of Diseases (ICD-11) of the World Health Organization.

There were 99 patients included in the study. Mean (SD) age of the patients was 11.5 (4.8) years old. Most patients were male sex (60.6%). The most common pain diagnoses were chronic cancer-related pain (43.4%) and chronic neuropathic pain (21.2%). For multidisciplinary management, 46 (46.5%) patients were sent for psychiatric consultation (95% CI 37.0-56.2), which turned out to be 36 (36.4%) patients who had mental health disorders (95% CI 27.6-46.2). Fifty-six (56.6%) patients had rehabilitation (95% CI 46.7-65.9). Twenty (20.2%) patients required both psychiatric and rehabilitation treatments. Gabapentinoids were used in 68 (68.7%) patients. Strong opioids via oral route were reported in 59 (59.6%) patients. Overall, 54 (54.5%) patients were able to be discharged from the service, while 27 (27.3%) patients died.

A significant proportion of children with chronic pain required psychiatric and rehabilitation management.