Trends in Medicalization of Children with Amplified Musculoskeletal Pain Syndrome

• Published in: Pain medicine (Malden, Mass.) Vol. 18; no. 5; pp. 825 - 831
• Main Authors: Kaufman, Elizabeth L., Tress, Jenna, Sherry, David D.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2017
• Subjects: Activities of Daily Living; Adolescent; Adult; Analgesics - supply & distribution; Child; Child, Preschool; Children; Drug Utilization - statistics & numerical data; Drug Utilization Review; Female; Humans; Longitudinal Studies; Male; Medical Overuse - statistics & numerical data; Medical records; Musculoskeletal Pain - diagnosis; Musculoskeletal Pain - drug therapy; Musculoskeletal Pain - epidemiology; Pain; Pain Measurement - drug effects; Pain Measurement - statistics & numerical data; Patients; Pennsylvania - epidemiology; Prevalence; Retrospective Studies; Risk Factors; Surgery; Treatment Outcome; Trends; Young Adult; Complex Regional Pain Syndrome; Medicalization; Medication Overuse; Fibromyalgia; Health Utilization; Child; Chronic Pain
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1093/pm/pnw188

Objective. The objective of this survey was to describe trends over time in medicalization of children with Amplified Musculoskeletal Pain Syndrome (AMPS). Design. A retrospective evaluation was conducted using self-reported data from patients presenting to the pain clinic between January 1, 2008 and December 31, 2014, who were diagnosed with AMPS. Setting and Subjects. This was a medical record review of 899 subjects ages 3–20 presenting with Amplified Musculoskeletal Pain Syndrome. Subjects were included if they presented to a single tertiary specialized clinic and obtained a diagnosis of AMPS between January 1, 2008 and December 31, 2014. Methods. Information collected from subjects’ medical records included: past medications, current outpatient medications, procedures, aids, therapies, studies, professionals seen, hospitalizations, and surgeries. Trends in medicalization were analyzed by year of initial visit. Results. Medication use, procedures, studies, therapies, professionals seen, hospitalizations, and surgeries in children with AMPS all increased significantly by year (P < 0.001). The degree of physical dysfunction, pain, and the use of aids did not significantly increase. Conclusions. Children with amplified musculoskeletal pain syndrome are becoming increasingly medicalized. Increased medicalization introduces risk of iatrogenic injury and burdens families with unnecessary medical costs. The significant increase in medicalization of children with AMPS is not related to an increase in patient reported pain, which is evidenced by the lack of significant increase in patients’ pain score, pain duration, or functional disability at the time of their initial evaluation.