TY - JOUR
T1 - Waiting for a Pediatric Chronic Pain Clinic Evaluation
T2 - A Prospective Study Characterizing Waiting Times and Symptom Trajectories
AU - Palermo, Tonya M.
AU - Slack, Margaret
AU - Zhou, Chuan
AU - Aaron, Rachel
AU - Fisher, Emma
AU - Rodriguez, Sade
N1 - Funding Information:
We thank Dr. Gary Walco, director of pain medicine at Seattle Children's Hospital, for his support of the study; Megan Lounds for providing study coordination; and especially the children and families who participated. Supported by a Center for Child Health, Behavior and Development stimulus grant (TP) and the National Institutes of Health (grant number K24HD060068) to T.M.P.
Publisher Copyright:
© 2018 the American Pain Society
PY - 2019/3
Y1 - 2019/3
N2 - Chronic pain during childhood is prevalent and costly, but the access to interdisciplinary pain care is limited. Studies investigating adults waiting for pain clinic evaluation found that symptoms and quality of life deteriorate over the waiting period, but little is known about the experience of adolescents. Therefore, we aimed to determine wait list times and the longitudinal trends of pain and physical, mental, and social health over a 12-week period. In total, 97 adolescents, aged 10 to 18 years (M = 14.7 years, 82% female), waiting for evaluation at an interdisciplinary pediatric pain clinic completed assessments at enrollment and at 4-, 8-, and 12-week follow-up. We performed a review of the medical record of attendance patterns 12 months later. Twelve adolescents and their parents also completed qualitative interviews, describing their experience of waiting for evaluation. Wait times averaged 197.5 days (range = 69–758 days) from the time of referral to the first-attended appointment, and 86.6% of youths completed appointments. Longitudinal repeated measures analyses demonstrated little improvement in pain or other domains of functioning over the 12-week period. In qualitative interviews, families described anxious anticipation for the upcoming appointment, combined with frustration in waiting. Findings highlight the need to consider approaches to reduce wait times and provide early intervention for youths awaiting pain clinic evaluation. Perspective: This study extends the literature on the characteristics and symptom trajectories of adolescents during the wait period for interdisciplinary pain clinic evaluation, described previously only in adults with chronic pain. Findings demonstrated an average wait time of 6.5 months, during which youths’ pain and physical and social health remained impaired.
AB - Chronic pain during childhood is prevalent and costly, but the access to interdisciplinary pain care is limited. Studies investigating adults waiting for pain clinic evaluation found that symptoms and quality of life deteriorate over the waiting period, but little is known about the experience of adolescents. Therefore, we aimed to determine wait list times and the longitudinal trends of pain and physical, mental, and social health over a 12-week period. In total, 97 adolescents, aged 10 to 18 years (M = 14.7 years, 82% female), waiting for evaluation at an interdisciplinary pediatric pain clinic completed assessments at enrollment and at 4-, 8-, and 12-week follow-up. We performed a review of the medical record of attendance patterns 12 months later. Twelve adolescents and their parents also completed qualitative interviews, describing their experience of waiting for evaluation. Wait times averaged 197.5 days (range = 69–758 days) from the time of referral to the first-attended appointment, and 86.6% of youths completed appointments. Longitudinal repeated measures analyses demonstrated little improvement in pain or other domains of functioning over the 12-week period. In qualitative interviews, families described anxious anticipation for the upcoming appointment, combined with frustration in waiting. Findings highlight the need to consider approaches to reduce wait times and provide early intervention for youths awaiting pain clinic evaluation. Perspective: This study extends the literature on the characteristics and symptom trajectories of adolescents during the wait period for interdisciplinary pain clinic evaluation, described previously only in adults with chronic pain. Findings demonstrated an average wait time of 6.5 months, during which youths’ pain and physical and social health remained impaired.
KW - Chronic pain
KW - evaluation
KW - pediatric
KW - waiting list
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U2 - 10.1016/j.jpain.2018.09.009
DO - 10.1016/j.jpain.2018.09.009
M3 - Article
C2 - 30291904
AN - SCOPUS:85056177316
SN - 1526-5900
VL - 20
SP - 339
EP - 347
JO - Journal of Pain
JF - Journal of Pain
IS - 3
ER -