Diagnostik und Therapie bei Kindern und Jugendlichen mit chronischem Schmerz: Zeitliche Entwicklung potenziell gesundheitsgefährdender Maßnahmen

BACKGROUND AND OBJECTIVES: Current research on the treatment of chronic pain in children suggests an increasing trend internationally in the quantity as well as invasiveness of diagnostic and therapeutic interventions. The objective of this research was to examine the interventions received by patients before starting specialized inpatient pain treatment. MATERIALS AND METHODS: A retrospective survey was conducted analyzing patient files from a tertiary children’s pain center from 2004, 2008, 2012 and 2016 (N = 585). In addition to diagnostic and therapeutic interventions, pain and patients’ characteristics were collected. The identified measures were subsequently evaluated by an interdisciplinary expert panel regarding their invasiveness, potential risk and degree of mental burden. RESULTS: An increase in diagnostic measures and medication was found up to 2012. Thereafter, a decreasing trend was identified (χ(2)(3) = 11.708; p = 0.008). Invasiveness (χ(2)(3) = 13.342; p = 0.004), risk (χ(2)(3) = 13.135; p = 0.004) and mental burden (χ(2)(3) = 14.403; p = 0.002) showed the same pattern of change. Patients with abdominal and limb pain are particularly at risk for highly invasive and high risk diagnostics. CONCLUSIONS: Evidence for an increase in diagnostic and therapeutic measures in chronic pain was found up to 2012. Patients presenting with certain complaints receive comparably more invasive, risky and burdensome measures.