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G361 Quality of Life in Adolescents with Severe Chronic Pain
  1. J Gauntlett-Gilbert,
  2. VJ Rogers,
  3. D Gavriloff
  1. Bath Centre for Pain Services, Royal National Hospital for Rheumatic Diseases NHS Foundation Trust, Bath, UK

Abstract

Aim Adolescents can present with chronic pain in a range of body locations (e.g. back, joints, abdomen or widespread pain). This can have a serious impact on their mood and functioning, which can be summarised by the variable ‘Quality of Life’ (QOL). However, QOL has not been examined extensively in the adolescent pain literature. One previous report suggested that QOL in this population is more closely associated with psychological variables than with pain intensity.

Methods Forty-one adolescent patients (median age 15.3 years, 90% female) attending a tertiary residential pain rehabilitation programme completed a battery of self-report measures before and after treatment. Patients had relatively severe pain and long-standing disability (median 49 months), with a range of diagnoses (primarily back pain, widespread idiopathic pain, Complex Regional Pain Syndrome). QOL was indexed by the PedsQL 4.0 generic module. We examined QOL in relation to other paediatric chronic conditions, its correlation with pain and psychological variables, and changes over treatment.

Results Adolescents in this sample experienced much worse Quality of Life than in a range of comparator conditions (e.g.diabetes, asthma, oncology groups). QOL was more closely correlated with acceptance of pain than with pain intensity itself. Despite the severe and long-standing nature of pain in this group, QOL improved significantly after treatment.

Conclusions Adolescents attending a tertiary specialist centre for chronic pain have exceptionally low QOL, and poorer scores than in many other conditions that are ostensibly more medically ’serious’. QOL was not associated with pain intensity per se. However, it is associated with ‘acceptance’ of pain, indicating that functioning is more associated with pain coping than with pain itself. This very poor level of QOL can be improved by appropriate intensive and specialist treatment, despite no overall improvement in pain scores.

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