The Changes Over 15 Years Within a Pediatric Chronic Pain Service.

Area of Science:

• Pediatric Pain Management
• Clinical Audit
• Healthcare Service Evaluation

Background:

• Chronic pain in children presents unique challenges in presentation and management.
• Evolving clinical guidelines necessitate regular audits to ensure adherence and assess service effectiveness.
• Assessing service delivery requires analysis of patient demographics, treatment patterns, and outcomes over time.

Purpose of the Study:

• To evaluate changes in the presentation and management of pediatric chronic pain over 15 years.
• To assess adherence to evolving clinical guidelines in a tertiary pediatric chronic pain service.
• To determine the effectiveness of the service in managing pediatric chronic pain.

Main Methods:

• Audit of electronic patient records (EPR) for pediatric chronic pain patients from 2010-2025.
• Inclusion of patients seen at least once in the chronic pain clinic.
• Grouping patients into epochs based on their last pain clinic appointment for comparative analysis.

Main Results:

• Increased proportion of patients with primary chronic pain diagnoses.
• Higher rates of patients reporting severe functional limitations (bedbound, walking aids, affected daily activities).
• Increased referrals for allied health services and a decrease in gabapentinoid prescribing, reflecting guideline adherence.

Conclusions:

• The service is encountering more complex pediatric chronic pain cases with increasing severity.
• Approximately 30% of patients show improvement and are discharged, indicating partial service effectiveness.
• Further research is needed to benchmark this service's outcomes against national standards.