(315) Pain and Somatic Symptoms at 2-5 Year Follow-Up after Intensive Interdisciplinary Pain Treatment

Abstract

There is a paucity of literature regarding long-term follow up of pediatric patients who have participated in intensive interdisciplinary pain treatment (IIPT) programs. Evidence suggests that pain and somatic symptoms in childhood often lead to increased pain and somatic in adulthood, but data is lacking in this population. To better understand the long-term outcomes of individuals who completed IIPT as youth, we surveyed 139 participants who had completed IIPT at least two years prior to the survey. We received 58 responses (42% response rate), all 2-5 years after program completion. Participants (age 18.9±2.0, 86% female) completed measures of pain and health status (including the Widespread Pain Index), medical utilization, and emotional functioning. They were also asked to characterize if their pain was “better” than before IIPT, if they considered it “resolved,” and if they had any new pain or other medical diagnoses. Contrary to results of adolescents who have not received intensive treatment, half (50%) of the current sample did not have fibromyalgia symptoms at follow up, and only 31% met criteria for fibromyalgia.1 Most (79%) rated their pain as better, and 45% described their pain as resolved, though 22% indicated new areas of pain and 9% reported a new pain-related diagnosis. Consistent with other studies of this population, these participants continued to have higher than typical medical utilization and reported elevated anxiety and depressive symptoms. Overall, the results show that while pain often improves into adulthood for patients who completed IIPT, other somatic symptoms, anxiety, and depression often persist or increase in this population. These results suggest the need for further study, particularly in light of the increased medical utilization, as ongoing medical focus and intervention could be a causal factor in maintaining or increasing disability into adulthood. (1. Kashikar-Zuck et al., Pediatrics, 2014) There is a paucity of literature regarding long-term follow up of pediatric patients who have participated in intensive interdisciplinary pain treatment (IIPT) programs. Evidence suggests that pain and somatic symptoms in childhood often lead to increased pain and somatic in adulthood, but data is lacking in this population. To better understand the long-term outcomes of individuals who completed IIPT as youth, we surveyed 139 participants who had completed IIPT at least two years prior to the survey. We received 58 responses (42% response rate), all 2-5 years after program completion. Participants (age 18.9±2.0, 86% female) completed measures of pain and health status (including the Widespread Pain Index), medical utilization, and emotional functioning. They were also asked to characterize if their pain was “better” than before IIPT, if they considered it “resolved,” and if they had any new pain or other medical diagnoses. Contrary to results of adolescents who have not received intensive treatment, half (50%) of the current sample did not have fibromyalgia symptoms at follow up, and only 31% met criteria for fibromyalgia.1 Most (79%) rated their pain as better, and 45% described their pain as resolved, though 22% indicated new areas of pain and 9% reported a new pain-related diagnosis. Consistent with other studies of this population, these participants continued to have higher than typical medical utilization and reported elevated anxiety and depressive symptoms. Overall, the results show that while pain often improves into adulthood for patients who completed IIPT, other somatic symptoms, anxiety, and depression often persist or increase in this population. These results suggest the need for further study, particularly in light of the increased medical utilization, as ongoing medical focus and intervention could be a causal factor in maintaining or increasing disability into adulthood. (1. Kashikar-Zuck et al., Pediatrics, 2014)