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Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
Published on: January 5, 2024
Characteristics of the Pediatric Chronic Pain Service in a Developing Country: A Retrospective Study
Taniga Kiatchai1, Sahatsa Mandee1, Skaorat Panchoowong1
1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
Insights
Many children with chronic pain need integrated care. This study highlights the importance of psychiatric and rehabilitation services for pediatric chronic pain patients, showing significant need and outcomes in Thailand.
Area of Science:
- Pediatric Pain Management
- Multidisciplinary Healthcare
- Clinical Outcomes Research
Background:
- Chronic pain affects a significant pediatric population, necessitating specialized care.
- Existing pediatric pain services may lack comprehensive multidisciplinary approaches.
- Understanding patient characteristics and management strategies is crucial for improving outcomes.
Purpose of the Study:
- To delineate the characteristics of pediatric patients with chronic pain.
- To describe the multidisciplinary management strategies employed.
- To evaluate patient outcomes within a tertiary care setting.
Main Methods:
- Retrospective analysis of 99 pediatric patients (0-17 years) from August 2021 to December 2023.
- Data collection included demographics, diagnoses (ICD-11), pain characteristics, and management interventions.
- Outcomes assessed included discharge status and mortality.
Main Results:
- Common diagnoses included chronic cancer-related (43.4%) and neuropathic pain (21.2%).
- A majority of patients received psychiatric consultation (46.5%) and/or rehabilitation (56.6%).
- Gabapentinoids (68.7%) and strong opioids (59.6%) were frequently prescribed; 54.5% were discharged, 27.3% died.
Conclusions:
- Pediatric chronic pain management requires a robust multidisciplinary approach.
- Psychiatric and rehabilitation services are essential components of care for this population.
- Further research should focus on optimizing integrated care models.
Objective:
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.
Methods:
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 11th revision of the International Classification of Diseases (ICD-11) of the World Health Organization.
Results:
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.
Conclusion:
A significant proportion of children with chronic pain required psychiatric and rehabilitation management.
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