Medication use among pediatric patients with chronic musculoskeletal pain syndromes at initial pain clinic evaluation

Jessica W Guite; David D Sherry; Esther W Jarvis; Margaret O Lewen; Sarosh Khan; Francis Wickham Kraemer

doi:10.2217/pmt-2017-0034

Medication use among pediatric patients with chronic musculoskeletal pain syndromes at initial pain clinic evaluation

Pain Manag. 2018 Jan;8(1):15-25. doi: 10.2217/pmt-2017-0034. Epub 2017 Dec 4.

Authors

Jessica W Guite^{1

2

3

4}, David D Sherry^{5

6}, Esther W Jarvis⁵, Margaret O Lewen^{1

2

5}, Sarosh Khan⁴, Francis Wickham Kraemer^{1

2}

Affiliations

¹ Department of Anesthesiology & Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
² Department of Anesthesiology & Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
³ Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT 06032, USA.
⁴ Center for Behavioral Health, Connecticut Children's Medical Center, Hartford, CT 06106, USA.
⁵ Department of Rheumatology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
⁶ Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.

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: CRPS; adolescents; opioids.

MeSH terms

Adolescent
Analgesics, Opioid / therapeutic use
Child
Chronic Pain / diagnosis
Chronic Pain / drug therapy*
Cross-Sectional Studies
Drug Prescriptions / statistics & numerical data
Female
Humans
Male
Musculoskeletal Pain / diagnosis
Musculoskeletal Pain / drug therapy*
Pain Management / statistics & numerical data*
Pain Measurement
Surveys and Questionnaires
Syndrome

Substances

Analgesics, Opioid

Grants and funding

R03 HD054596/HD/NICHD NIH HHS/United States