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Objectives Chronic pain in children and adolescents is a complex condition with debilitating consequences. The objectives of this service evaluation are to analyse the demographic variables associated with paediatric chronic pain using data from a tertiary hospital in England. The influence of age, gender, ethnicity, pain location, co-morbidities and socioeconomic status on chronic pain prevalence will be investigated. Further analysis of treatment modalities will be conducted to evaluate the effectiveness of current service provision. Referral-to-treatment waiting times will be explored to identify patient and system level implications. Understanding the influence of these parameters on chronic pain trajectories will increase the awareness of chronic pain within local communities and amongst general practitioners, paediatricians, Child and Adolescent Mental Health Services and allied healthcare specialists. Methods Involved a hospital-record analysis of 117 patients (81 females and 36 males) aged 3 to 16 years. Socioeconomic status was determined using English Indices of Deprivation data. Results Showed a higher prevalence of chronic pain amongst females (69%) and with advancing age in both genders. The most frequently reported pain types were lower limb (31%) and back (15%). Combined physical and pharmacological interventions were most routinely recommended. The highest proportion of patients (28%) lived in the most disadvantaged areas across multiple deprivation domains. 63% of patients received consultant-led treatment beyond the 18-week government target, with 19.74 weeks being the average waiting time post-referral. Conclusion Include the need for a more integrated biopsychosocial treatment approach, focusing on parent-child psychological comorbidities. Expanding regional health networks will target ethnic and deprived sub-sectors, encouraging their engagement with pain services. Initiatives for tailored, clinician-led treatments could provide children with more freedom to narrate their pain story, minimising self-isolation whilst supporting therapeutic change. Aims of creating integrated care plans through social prescribing interventions involving link workers within chronic pain teams could better encourage pain self-management and health equity. Establishing links between community-based and hospital-led care by exposing chronic pain patients to school-oriented activities can aid in addressing the social determinants of health influencing chronic pain. Greater empowerment, self-esteem, purpose and community connection may result. Social prescribing can bridge the gap for patients on waiting lists alongside integration into biopsychosocial treatment plans, thus moving away from traditional disease-specific management. Follow-up evaluations of the efficacy of link worker referrals is crucial in identifying health improvements. However, scope remains for increasing social-prescriber training to aid patients in overcoming physical and psychological barriers to engagement in patient-driven activities.
Mamoowala et al. (Tue,) studied this question.