David Sommerfield1, Anna Hilyard1, Suzi Taylor1, Vance Locke1
1) Australia
There is increasing evidence that group programs can be effective in paediatric chronic pain. A six-week interdisciplinary pain management group program was developed for children and adolescents and their parents. It was hypothesised that the program would improve function and reduce hospital attendances. We present on some of these variables after our first five programs.
Participants were recruited prospectively from within a paediatric tertiary referral pain clinic. The team included an occupational therapist, physiotherapist, clinical psychologist, teacher and pain medicine specialist. The program used a cognitive behavioural approach. Children attended for 60hrs and parents 30 hours respectively in separate sessions over six weeks on an outpatient basis.
Physical (6 min walk test and Functional Disability Index FDI) and psychological functioning (Revised Children’s Anxiety Depression Score, Bath-Parent Impact Questionnaire), school attendance, hospital and emergency attendances were measured at baseline, completion, 3 months and where available 6 and 12 months post-program.
Repeated measure ANOVA analysis was performed with P<0.05 used as a significant change.
30 patients completed the program in 5 groups between 1/6/15 and 31/10/2016. Complete data sets were only available for 17 participants. There were improvements in physical, social and psychological domains at 3 months and this was maintained in some to 12 months. For example, FDI score improved from a mean of 26.5 to 12.7 (p<.01) and the 6 Minute Walk from a mean of 259m to 492m (p<.01), psychological function (eg change in RCADS Depression from mean 13.4 to 10.3 p<.01). Percentage school attendance was improved and ED attendances decreased in the six months prior compared to six months after completing the program.
This study supports the growing evidence for the efficacy of paediatric interdisciplinary group pain management programs.
