ABSTRACT
OBJECTIVE: This study examined key functional outcomes following a 3-week interdisciplinary pediatric pain rehabilitation program for adolescents with chronic pain. Maintenance of gains was evaluated at 3-month follow-up. METHODS: Participants included 171 adolescents (12 to 18 y of age) with chronic pain who completed a hospital-based outpatient pediatric pain rehabilitation program. Participants completed measures of functional disability, depressive symptoms, pain catastrophizing, opioid use, school attendance, and pain severity at admission, discharge, and at 3-month follow-up. RESULTS: Similar to other interdisciplinary pediatric pain rehabilitation program outcome studies, significant improvements were observed at the end of the program. These improvements appeared to be maintained or further improved at 3-month follow-up. Nearly 14% of the patients were taking daily opioid medication at admission to the program. All adolescents were completely tapered off of these medications at the end of the 3-week program and remained abstinent at 3-month follow-up. DISCUSSION: This study adds to the available data supporting interdisciplinary pediatric pain rehabilitation as effective in improving functioning and psychological distress even when discontinuing opioids. Implications for future research and limitations of the study are discussed.
Subject(s)
Chronic Pain/rehabilitation , Pain Management , Adolescent , Ambulatory Care , Analgesics, Opioid/therapeutic use , Catastrophization , Child , Chronic Pain/psychology , Depression/rehabilitation , Disability Evaluation , Female , Follow-Up Studies , Humans , Male , Pain Management/methods , Pain Measurement , Schools , Treatment OutcomeABSTRACT
Significant functional impairment and psychological distress have been observed in adolescent patients with postural orthostatic tachycardia syndrome (POTS). Interdisciplinary rehabilitation programs have been shown to be beneficial in the treatment of chronic pain in adults and adolescents. Only preliminary data have examined interdisciplinary rehabilitation efforts in patients with POTS. This study evaluated the impact of an interdisciplinary rehabilitation program on the functional impairment and psychological distress in 33 adolescents diagnosed with POTS. Patients included in the study were adolescents ages 11 to 18 diagnosed with POTS. Measures completed at admission and discharge from the program included the Functional Disability Index, Center for Epidemiological Studies-Depression-Child scale, and the Pain Catastrophizing Scale for Children. After participation in the 3-week program, adolescents with POTS demonstrated a significant increase in overall functional ability and significant reductions in depression and catastrophizing.
Subject(s)
Activities of Daily Living/psychology , Postural Orthostatic Tachycardia Syndrome/psychology , Postural Orthostatic Tachycardia Syndrome/therapy , Stress, Psychological/psychology , Stress, Psychological/therapy , Adolescent , Catastrophization/complications , Catastrophization/psychology , Catastrophization/therapy , Child , Cognitive Behavioral Therapy/methods , Depressive Disorder/complications , Depressive Disorder/psychology , Depressive Disorder/therapy , Diet/methods , Fatigue Syndrome, Chronic/complications , Fatigue Syndrome, Chronic/psychology , Fatigue Syndrome, Chronic/therapy , Female , Health Education/methods , Humans , Male , Occupational Therapy/methods , Physical Therapy Modalities , Postural Orthostatic Tachycardia Syndrome/complications , Stress, Psychological/complicationsABSTRACT
This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5-10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health-care cost savings.
