ABSTRACT How do we know if a service is working? How has the presentation and management of children with chronic pain changed over the last fifteen years and what demonstrates adherence to changing guidelines? This audit of a large tertiary pediatric chronic pain service assessed relevant multivariate data gathered over the last 15 years to try to give an insight and answer these questions. All patients with electronic patient records (EPR) referred to the chronic pain service in the West of Scotland from 2010 to 2025 were audited. Any patients not seen in clinic at least once were excluded. Patients were grouped into epochs based on their most recent or last pain clinic appointment. 728 patients were included. The audit found that the service is seeing a greater proportion of patients with primary chronic pain diagnoses, accounting for over 40% of patients in the last epoch ( p = 0.003). Significantly greater proportions of patients reported being bedbound ( p < 0.001), needing walking aids ( p = < 0.001) or having their activities of daily living being affected by pain ( p = 0.05) in later epochs. The average number of referrals per patient, including referrals for physiotherapy and psychology increased. Although the average number of medications taken by patients increased, the proportion of patients taking gabapentinoids decreased ( p = 0.180). This reflects adherence to current recommendations to reduce gabapentinoid prescribing, although the change was not statistically significant. There was a reduction in the percentage of patients discharged due to pain improvement and a greater proportion being transferred to adult services. The results suggest that patients are presenting with more severe complex pain, increasingly with no secondary cause. The service appears to be effective for approximately 30% of patients, who are discharged due to pain improvement. It is unknown how this compares to other services around the country.
Buechner et al. (Wed,) studied this question.