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Effectiveness of interdisciplinary interventions in paediatric chronic pain management: a systematic review and subset meta-analysis

Effectiveness of interdisciplinary interventions in paediatric chronic pain management: a systematic review and subset meta-analysis
Effectiveness of interdisciplinary interventions in paediatric chronic pain management: a systematic review and subset meta-analysis

Background: Paediatric chronic pain is a significant problem that can have devastating impacts on quality of life. Multimodal interdisciplinary interventions are the mainstay of paediatric treatment. The aim of this article is to provide a comprehensive review of the effectiveness of interdisciplinary interventions in the management of paediatric chronic pain. Methods: Studies were identified via a search of nine databases. The search strategy included concept blocks pertaining to type of pain, study population, and type of intervention. Eligible studies reported the effects of an intervention co-ordinated by two or more healthcare professionals of different disciplines, and recruited a sample aged 22 yr or below with chronic pain. Twenty-eight studies were included, and 21 provided data for inclusion in between- and within-groups meta-analyses. Results: Patients randomised to interdisciplinary interventions reported significantly lower pain intensity 0–1 month post-intervention compared with patients randomised to the control groups. Within-groups analysis of patients receiving interdisciplinary interventions showed significant improvements pre- to post-intervention in pain intensity, functional disability, anxiety, depression, catastrophising, school attendance, school functioning, and pain acceptance. Few differences were found between interventions delivered in inpatient vs outpatient settings. Significant heterogeneity due mainly to differing outcome variables and intervention content was found in most analyses. Conclusions: Overall, interdisciplinary interventions show promise in providing a range of clinical benefits for children with chronic pain. Methodologically robust randomised controlled trials using standardised outcome measures are needed, however, to guide clinical care.

chronic pain, interdisciplinary pain clinic, meta-analysis, multimodal analgesia, paediatrics, systematic review
0007-0912
e359-e371
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558
Johnstone, Lauren
6617db9c-6b16-4bb5-a669-18f9485e42b8
Lilley, Suzanne
c90a0140-d6a3-4274-9d47-b9d3efbe6fa5
Caes, Line
1ca23ff5-962a-4bab-8dda-dbdce0361e19
Williams, Glyn
abdc5e32-4fed-4531-b25b-2d593176e72c
Schoth, Daniel Eric
73f3036e-b8cb-40b2-9466-e8e0f341fdd5
Liossi, Christina
fd401ad6-581a-4a31-a60b-f8671ffd3558
Johnstone, Lauren
6617db9c-6b16-4bb5-a669-18f9485e42b8
Lilley, Suzanne
c90a0140-d6a3-4274-9d47-b9d3efbe6fa5
Caes, Line
1ca23ff5-962a-4bab-8dda-dbdce0361e19
Williams, Glyn
abdc5e32-4fed-4531-b25b-2d593176e72c
Schoth, Daniel Eric
73f3036e-b8cb-40b2-9466-e8e0f341fdd5

Liossi, Christina, Johnstone, Lauren, Lilley, Suzanne, Caes, Line, Williams, Glyn and Schoth, Daniel Eric (2019) Effectiveness of interdisciplinary interventions in paediatric chronic pain management: a systematic review and subset meta-analysis. British Journal of Anaesthesia, 123 (2), e359-e371. (doi:10.1016/j.bja.2019.01.024).

Record type: Review

Abstract

Background: Paediatric chronic pain is a significant problem that can have devastating impacts on quality of life. Multimodal interdisciplinary interventions are the mainstay of paediatric treatment. The aim of this article is to provide a comprehensive review of the effectiveness of interdisciplinary interventions in the management of paediatric chronic pain. Methods: Studies were identified via a search of nine databases. The search strategy included concept blocks pertaining to type of pain, study population, and type of intervention. Eligible studies reported the effects of an intervention co-ordinated by two or more healthcare professionals of different disciplines, and recruited a sample aged 22 yr or below with chronic pain. Twenty-eight studies were included, and 21 provided data for inclusion in between- and within-groups meta-analyses. Results: Patients randomised to interdisciplinary interventions reported significantly lower pain intensity 0–1 month post-intervention compared with patients randomised to the control groups. Within-groups analysis of patients receiving interdisciplinary interventions showed significant improvements pre- to post-intervention in pain intensity, functional disability, anxiety, depression, catastrophising, school attendance, school functioning, and pain acceptance. Few differences were found between interventions delivered in inpatient vs outpatient settings. Significant heterogeneity due mainly to differing outcome variables and intervention content was found in most analyses. Conclusions: Overall, interdisciplinary interventions show promise in providing a range of clinical benefits for children with chronic pain. Methodologically robust randomised controlled trials using standardised outcome measures are needed, however, to guide clinical care.

Full text not available from this repository.

More information

Accepted/In Press date: 15 January 2019
e-pub ahead of print date: 1 March 2019
Published date: 1 August 2019
Keywords: chronic pain, interdisciplinary pain clinic, meta-analysis, multimodal analgesia, paediatrics, systematic review

Identifiers

Local EPrints ID: 431425
URI: http://eprints.soton.ac.uk/id/eprint/431425
ISSN: 0007-0912
PURE UUID: 9351b047-0c7a-4253-8901-c725712ede16
ORCID for Christina Liossi: ORCID iD orcid.org/0000-0003-0627-6377

Catalogue record

Date deposited: 31 May 2019 16:30
Last modified: 07 Oct 2020 01:52

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