儿童腹痛认知行为疗法后的医疗保健利用:一项随机临床试验
Lauren M Fussner1, Samuel Vyortkin2, Steven J Pierce3
1Comprehensive Pediatric Psychology, LLC, Columbus, Ohio.
The Clinical journal of pain
|August 4, 2025
概括
认知行为疗法 (CBT) 可能会减少儿童功能性腹痛障碍 (FAPD) 的医疗保健使用. 这项研究将CBT (ADAPT) 与常规治疗 (TAU) 进行了比较,发现CBT组的诊所和医院访问可能减少.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 儿童和青少年精神病学
- 行为健康干预措施 行为健康干预
背景情况:
- 功能性腹痛障碍 (FAPD) 显著影响儿童的生活质量,并导致大量的医疗保健利用.
- 了解FAPD不同治疗方法的比较有效性对于优化患者护理和资源配置至关重要.
研究的目的:
- 评估和比较FAPD接受认知行为疗法 (CBT) 和通常治疗 (TAU) 的儿科患者的医疗利用率 (HCU).
- 评估Aim to Decrease Anxiety and Pain Treatment (ADAPT) 的影响,这是一个基于证据的CBT干预措施,对患有FAPD的年轻人的HCU指标.
主要方法:
- 一项随机临床试验分配了78名患有FAPD的儿科患者 (年龄为9-14) 接受ADAPT (CBT) 或TAU.
- 医疗保健利用率被客观地通过电子医疗记录测量,干预后12个月,包括门诊胃肠道和心理/精神病学访问,急诊室访问和住院住院.
- 使用计数回归模型来分析ADAPT对HCU的影响.
主要成果:
- 在研究样本中,子专业和紧急服务的总体HCU很低.
- 与TAU组相比,接受ADAPT (CBT) 的参与者显示出较少的胃肠病诊所访问 (IRR=0.86),心理学/精神病学访问 (IRR=0.84) 和住院治疗 (IRR=0.37) 的潜在趋势,尽管置信区间很宽.
结论:
- 研究结果表明,在接受CBT治疗的儿科FAPD患者与TAU治疗的儿科FAPD患者之间,HCU的潜在变化.
- 需要进一步的研究,以阐明认知行为干预对儿科FAPD和相关肠-脑相互作用障碍 (DGBI) HCU的影响.
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