Medication Use among Pediatric Patients with Chronic Musculoskeletal Pain Syndromes at Initial Pain Clinic Evaluation

Abstract

Aim: To characterize medication use by adolescents with chronic musculoskeletal pain syndromes before an initial multidisciplinary clinic visit. Patients & methods: A cross-sectional sample of 120 adolescents and parents reported on standardized assessment measures, with medication use data extracted from the medical chart and categorized. Results: On average, 3.2 medications were reported; 70% used more than one pain-specific medication including opioids (17%), nonopioids (31%), psychotropics/neuropathics (45%) and other medications (13%). Adolescents with complex regional pain syndrome consistently reported greatest use of opioid, psychotropic/neuropathic and other pain medications. A regression model explained 17% of the variance in pain medication use. Nonpain medication use and disability contributed unique variance – pain duration and intensity did not. Conclusion: Greater attention to factors contributing to prescriptive practices, medication use and long-term outcomes is warranted.

Keywords::

• adolescents
• CRPS
• opioids

Acknowledgements

The authors express their gratitude to the participating patients and parents who made this project possible. Many thanks to Sohee Kim, Eugenia Chan, Stephanie V Hernandez and Rebecca L McCue for their contributions as research assistants on the project, and to the staff of the Pediatric Pain Management Clinic at CHOP.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the NIH or The Children’s Hospital of Philadelphia.

Financial & competing interests disclosure

The data collected for this project were supported by award number R03HD054596 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development and an award from the Foerderer Fund for Excellence at The Children’s Hospital of Philadelphia (CHOP) to JW Guite, while located at the Children’s Hospital of Philadelphia. JW Guite is currently located at the Center for Behavioral Health, Connecticut Children’s Medical Center and the Department of Pediatrics, University of Connecticut School of Medicine and may be contacted at [email protected]. DD Sherry’s effort on this project was further supported by The CHOP Women’s Committee, and a gift from Karen & Kristine Lubert. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Additional information

Funding

The data collected for this project were supported by award number R03HD054596 from the Eunice Kennedy Shriver National Institute of Child Health Human Development and an award from the Foerderer Fund for Excellence at The Children�s Hospital of Philadelphia (CHOP) to JW Guite, while located at the Children�s Hospital of Philadelphia. JW Guite is currently located at the Center for Behavioral Health, Connecticut Children�s Medical Center and the Department of Pediatrics, University of Connecticut School of Medicine and may be contacted at [email protected]. DD Sherry�s effort on this project was further supported by The CHOP Women�s Committee, and a gift from Karen Kristine Lubert. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript