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2019 | Schmerztherapie bei Kindern | OriginalPaper | Buchkapitel

8. Wirksamkeit des Schmerztherapieprogramms

verfasst von : L. Stahlschmidt, M. Dobe, B. Zernikow, J. Wager

Erschienen in: Therapie von Schmerzstörungen im Kindes- und Jugendalter

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Unbehandelte oder unzureichend behandelte chronische Schmerzen im Kindesalter persistieren häufig bis ins Erwachsenenalter. Am Anfang dieses Kapitels werden kurz die Langzeitfolgen einer unzureichenden Therapie bzw. Nicht-Behandlung chronischer Schmerzen im Kindes- und Jugendalter beleuchtet. Anschließend wird der Frage nachgegangen, inwiefern Schmerzstörungen im Kindes- und Jugendalter im stationären Setting erfolgreich behandelt werden können. Der Fokus liegt auf der Wirksamkeit der stationären Schmerztherapie am DKSZ. Darüber hinaus werden kurz Ergebnisse internationaler Wirksamkeitsstudien zu vergleichbaren Schmerzprogrammen für Kinder und Jugendliche vorgestellt.
Literatur
Zurück zum Zitat Brattberg G (2004) Do pain problems in young school children persist into early adulthood? A 13-year follow-up. Eur J Pain 8:187–199PubMedCrossRef Brattberg G (2004) Do pain problems in young school children persist into early adulthood? A 13-year follow-up. Eur J Pain 8:187–199PubMedCrossRef
Zurück zum Zitat Brna P, Dooley J, Gordon K, Dewan T (2005) The prognosis of childhood headache: a 20-year follow-up. Arch Pediatr Adolesc Med 159:1157–1160PubMedCrossRef Brna P, Dooley J, Gordon K, Dewan T (2005) The prognosis of childhood headache: a 20-year follow-up. Arch Pediatr Adolesc Med 159:1157–1160PubMedCrossRef
Zurück zum Zitat Dobe M, Hechler T, Behlert J, Kosfelder J, Zernikow B (2011) Schmerztherapie bei chronisch schmerzkranken, schwer beeinträchtigten Kindern und Jugendlichen. Schmerz 25:411–422PubMedCrossRef Dobe M, Hechler T, Behlert J, Kosfelder J, Zernikow B (2011) Schmerztherapie bei chronisch schmerzkranken, schwer beeinträchtigten Kindern und Jugendlichen. Schmerz 25:411–422PubMedCrossRef
Zurück zum Zitat Ellert U, Neuhauser H, Roth-Isigkeit A (2007) Schmerzen bei Kindern und Jugendlichen in Deutschland: Prävalenz und Inanspruchnahme medizinischer Leistungen. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:711–717CrossRef Ellert U, Neuhauser H, Roth-Isigkeit A (2007) Schmerzen bei Kindern und Jugendlichen in Deutschland: Prävalenz und Inanspruchnahme medizinischer Leistungen. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:711–717CrossRef
Zurück zum Zitat Evans JR, Benore E, Banez GA (2016) The cost-effectiveness of intensive interdisciplinary pediatric chronic pain rehabilitation. J Pediatr Psychol 41:849–856PubMedCrossRef Evans JR, Benore E, Banez GA (2016) The cost-effectiveness of intensive interdisciplinary pediatric chronic pain rehabilitation. J Pediatr Psychol 41:849–856PubMedCrossRef
Zurück zum Zitat Fearon P, Hotopf M (2001) Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study. Br Med J 322:1145–1148CrossRef Fearon P, Hotopf M (2001) Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study. Br Med J 322:1145–1148CrossRef
Zurück zum Zitat Flack F, Stahlschmidt L, Dobe M, Hirschfeld G, Kesper A, Michalak J, Wager J, Zernikow B (2018) Efficacy of adding interoceptive exposure to intensive interdisciplinary treatment for adolescents with chronic pain: a randomized controlled trial. Pain 159:2223. [Epub vor Druck]PubMedCrossRef Flack F, Stahlschmidt L, Dobe M, Hirschfeld G, Kesper A, Michalak J, Wager J, Zernikow B (2018) Efficacy of adding interoceptive exposure to intensive interdisciplinary treatment for adolescents with chronic pain: a randomized controlled trial. Pain 159:2223. [Epub vor Druck]PubMedCrossRef
Zurück zum Zitat Frerker M, Hechler T, Schmidt P, Zernikow B (2016) Schmerzbezogenes Elternverhalten. Schmerz 30:241–247PubMedCrossRef Frerker M, Hechler T, Schmidt P, Zernikow B (2016) Schmerzbezogenes Elternverhalten. Schmerz 30:241–247PubMedCrossRef
Zurück zum Zitat Groenewald CB, Essner BS, Wright D, Fesinmeyer MD, Palermo TM (2014) The economic costs of chronic pain among a cohort of treatment-seeking adolescents in the United States. J Pain 15:925–933PubMedPubMedCentralCrossRef Groenewald CB, Essner BS, Wright D, Fesinmeyer MD, Palermo TM (2014) The economic costs of chronic pain among a cohort of treatment-seeking adolescents in the United States. J Pain 15:925–933PubMedPubMedCentralCrossRef
Zurück zum Zitat Hechler T, Dobe M, Kosfelder J, Damschen U, Hübner B, Blankenburg M, Sauer C, Zernikow B (2009) Effectiveness of a three-week multimodal inpatient pain treatment for adolescents suffering from chronic pain: statistical and clinical significance. Clin J Pain 25:156–166PubMedCrossRef Hechler T, Dobe M, Kosfelder J, Damschen U, Hübner B, Blankenburg M, Sauer C, Zernikow B (2009) Effectiveness of a three-week multimodal inpatient pain treatment for adolescents suffering from chronic pain: statistical and clinical significance. Clin J Pain 25:156–166PubMedCrossRef
Zurück zum Zitat Hechler T, Blankenburg M, Dobe M, Kosfelder J, Hübner B, Zernikow B (2010a) Effectiveness of a multimodal inpatient treatment for pediatric chronic pain: a comparison between children and adolescents. Eur J Pain 14:97.e91–97.e99CrossRef Hechler T, Blankenburg M, Dobe M, Kosfelder J, Hübner B, Zernikow B (2010a) Effectiveness of a multimodal inpatient treatment for pediatric chronic pain: a comparison between children and adolescents. Eur J Pain 14:97.e91–97.e99CrossRef
Zurück zum Zitat Hechler T, Dobe M, Damschen U, Blankenburg M, Schroeder S, Kosfelder J, Zernikow B (2010b) The pain provocation technique for adolescents with chronic pain: preliminary evidence for its effectiveness. Pain Med 11:897–910PubMedCrossRef Hechler T, Dobe M, Damschen U, Blankenburg M, Schroeder S, Kosfelder J, Zernikow B (2010b) The pain provocation technique for adolescents with chronic pain: preliminary evidence for its effectiveness. Pain Med 11:897–910PubMedCrossRef
Zurück zum Zitat Hechler T, Dobe M, Zernikow B (2010c) Commentary: a worldwide call for multimodal inpatient treatment for children and adolescents suffering from chronic pain and pain-related disability. J Pediatr Psychol 35:138–140PubMedCrossRef Hechler T, Dobe M, Zernikow B (2010c) Commentary: a worldwide call for multimodal inpatient treatment for children and adolescents suffering from chronic pain and pain-related disability. J Pediatr Psychol 35:138–140PubMedCrossRef
Zurück zum Zitat Hechler T, Kosfelder J, Vocks S, Mönninger T, Blankenburg M, Dobe M, Gerlach AL, Denecke H, Zernikow B (2010d) Changes in pain-related coping strategies and their importance for treatment outcome following multimodal inpatient treatment: does sex matter? J Pain 11:472–483PubMedCrossRef Hechler T, Kosfelder J, Vocks S, Mönninger T, Blankenburg M, Dobe M, Gerlach AL, Denecke H, Zernikow B (2010d) Changes in pain-related coping strategies and their importance for treatment outcome following multimodal inpatient treatment: does sex matter? J Pain 11:472–483PubMedCrossRef
Zurück zum Zitat Hechler T, Martin A, Blankenburg M, Schroeder S, Kosfelder J, Hölscher L, Denecke H, Zernikow B (2011) Specialized multimodal outpatient treatment for children with chronic pain: treatment pathways and long-term outcome. Eur J Pain 15:976–984PubMedCrossRef Hechler T, Martin A, Blankenburg M, Schroeder S, Kosfelder J, Hölscher L, Denecke H, Zernikow B (2011) Specialized multimodal outpatient treatment for children with chronic pain: treatment pathways and long-term outcome. Eur J Pain 15:976–984PubMedCrossRef
Zurück zum Zitat Hechler T, Ruhe AK, Schmidt P, Hirsch J, Wager J, Dobe M, Krummenauer F, Zernikow B (2014a) Inpatient-based intensive interdisciplinary pain treatment for highly impaired children with severe chronic pain: randomized controlled trial of efficacy and economic effects. Pain 155:118–128PubMedCrossRef Hechler T, Ruhe AK, Schmidt P, Hirsch J, Wager J, Dobe M, Krummenauer F, Zernikow B (2014a) Inpatient-based intensive interdisciplinary pain treatment for highly impaired children with severe chronic pain: randomized controlled trial of efficacy and economic effects. Pain 155:118–128PubMedCrossRef
Zurück zum Zitat Hechler T, Wager J, Zernikow B (2014b) Chronic pain treatment in children and adolescents: less is good, more is sometimes better. BMC Pediatr 14:262PubMedPubMedCentralCrossRef Hechler T, Wager J, Zernikow B (2014b) Chronic pain treatment in children and adolescents: less is good, more is sometimes better. BMC Pediatr 14:262PubMedPubMedCentralCrossRef
Zurück zum Zitat Hechler T, Kanstrup M, Holley AL, Simons LE, Wicksell R, Hirschfeld G, Zernikow B (2015) Systematic review on intensive interdisciplinary pain treatment of children with chronic pain. Pediatrics 136:115–127PubMedCrossRef Hechler T, Kanstrup M, Holley AL, Simons LE, Wicksell R, Hirschfeld G, Zernikow B (2015) Systematic review on intensive interdisciplinary pain treatment of children with chronic pain. Pediatrics 136:115–127PubMedCrossRef
Zurück zum Zitat Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C (2006) The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine (Phila Pa 1976) 31:468–472CrossRef Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C (2006) The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine (Phila Pa 1976) 31:468–472CrossRef
Zurück zum Zitat Hirschfeld G, Hechler T, Dobe M, Wager J, Blankenburg M, Kosfelder J, Zernikow B (2013) Maintaining lasting improvements: one-year follow-up of children with severe chronic pain undergoing multimodal inpatient treatment. J Pediatr Psychol 38:224–236PubMedCrossRef Hirschfeld G, Hechler T, Dobe M, Wager J, Blankenburg M, Kosfelder J, Zernikow B (2013) Maintaining lasting improvements: one-year follow-up of children with severe chronic pain undergoing multimodal inpatient treatment. J Pediatr Psychol 38:224–236PubMedCrossRef
Zurück zum Zitat Hogan M-E, Taddio A, Katz J, Shah V, Krahn M (2016) Incremental health care costs for chronic pain in Ontario, Canada: a population-based matched cohort study of adolescents and adults using administrative data. Pain 157:1626–1633PubMedCrossRef Hogan M-E, Taddio A, Katz J, Shah V, Krahn M (2016) Incremental health care costs for chronic pain in Ontario, Canada: a population-based matched cohort study of adolescents and adults using administrative data. Pain 157:1626–1633PubMedCrossRef
Zurück zum Zitat Huguet A, Miro J (2008) The severity of chronic paediatric pain: an epidemiological study. J Pain 9:226–236PubMedCrossRef Huguet A, Miro J (2008) The severity of chronic paediatric pain: an epidemiological study. J Pain 9:226–236PubMedCrossRef
Zurück zum Zitat Kaczynski KJ, Claar RL, Logan DE (2009) Testing gender as a moderator of associations between psychosocial variables and functional disability in children and adolescents with chronic pain. J Pediatr Psychol 34:738–748PubMedCrossRef Kaczynski KJ, Claar RL, Logan DE (2009) Testing gender as a moderator of associations between psychosocial variables and functional disability in children and adolescents with chronic pain. J Pediatr Psychol 34:738–748PubMedCrossRef
Zurück zum Zitat van Leeuwen MT, Blyth FM, March LM, Nicholas MK, Cousins MJ (2006) Chronic pain and reduced work effectiveness: the hidden cost to Australian employers. Eur J Pain 10:161–166PubMedCrossRef van Leeuwen MT, Blyth FM, March LM, Nicholas MK, Cousins MJ (2006) Chronic pain and reduced work effectiveness: the hidden cost to Australian employers. Eur J Pain 10:161–166PubMedCrossRef
Zurück zum Zitat Logan DE, Simons LE, Stein MJ, Chastain L (2008) School impairment in adolescents with chronic pain. J Pain 9:407–416PubMedCrossRef Logan DE, Simons LE, Stein MJ, Chastain L (2008) School impairment in adolescents with chronic pain. J Pain 9:407–416PubMedCrossRef
Zurück zum Zitat Mäntyselkä PT, Kumpusalo EA, Ahonen RS, Takala JK (2002) Direct and indirect costs of managing patients with musculoskeletal pain – challenge for health care. Eur J Pain 6:141–148PubMedCrossRef Mäntyselkä PT, Kumpusalo EA, Ahonen RS, Takala JK (2002) Direct and indirect costs of managing patients with musculoskeletal pain – challenge for health care. Eur J Pain 6:141–148PubMedCrossRef
Zurück zum Zitat Mirovsky Y, Jakim I, Halperin N, Lev L (2002) Non-specific back pain in children and adolescents: a prospective study until maturity. J Pediatr Orthop 11:275–278 Mirovsky Y, Jakim I, Halperin N, Lev L (2002) Non-specific back pain in children and adolescents: a prospective study until maturity. J Pediatr Orthop 11:275–278
Zurück zum Zitat Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JAM, Bohnen AM, van Suijlekom-Smit LWA, Passchier J, van der Wouden JC (2000) Pain in children and adolescents: a common experience. Pain 87:51–58PubMedCrossRef Perquin CW, Hazebroek-Kampschreur AA, Hunfeld JAM, Bohnen AM, van Suijlekom-Smit LWA, Passchier J, van der Wouden JC (2000) Pain in children and adolescents: a common experience. Pain 87:51–58PubMedCrossRef
Zurück zum Zitat Pradalier A, Auray JP, El Hasnaoui A, Alzahouri K, Dartigues JF, Duru G, Henry P, Lanteri-Minet M, Lucas C, Chazot G, Gaudin AF (2004) Economic impact of migraine and other episodic headaches in France: data from the grim2000 study. Pharmacoeconomics 22:985–999PubMedCrossRef Pradalier A, Auray JP, El Hasnaoui A, Alzahouri K, Dartigues JF, Duru G, Henry P, Lanteri-Minet M, Lucas C, Chazot G, Gaudin AF (2004) Economic impact of migraine and other episodic headaches in France: data from the grim2000 study. Pharmacoeconomics 22:985–999PubMedCrossRef
Zurück zum Zitat Ruhe A, Wager J, Schmidt P, Zernikow B (2013) Familiäre finanzielle Belastung durch chronische Schmerzen im Kindes- und Jugendalter. Selbsteinschätzung der Krankheitskosten für betroffene Familien vor und nach einer stationären interdisziplinären Schmerztherapie. Schmerz 27:577–587PubMedCrossRef Ruhe A, Wager J, Schmidt P, Zernikow B (2013) Familiäre finanzielle Belastung durch chronische Schmerzen im Kindes- und Jugendalter. Selbsteinschätzung der Krankheitskosten für betroffene Familien vor und nach einer stationären interdisziplinären Schmerztherapie. Schmerz 27:577–587PubMedCrossRef
Zurück zum Zitat Ruhe AK, Frosch M, Wager J, Linder R, Pfenning I, Sauerland D, Zernikow B (2017) Health care utilization and cost in children and adolescents with chronic pain: analysis of health care claims data one year before and after intensive interdisciplinary pain treatment. Clin J Pain 33:767–776PubMedCrossRef Ruhe AK, Frosch M, Wager J, Linder R, Pfenning I, Sauerland D, Zernikow B (2017) Health care utilization and cost in children and adolescents with chronic pain: analysis of health care claims data one year before and after intensive interdisciplinary pain treatment. Clin J Pain 33:767–776PubMedCrossRef
Zurück zum Zitat Shelby GD, Shirkey KC, Sherman AL, Beck JE, Haman K, Shears AR, Horst SN, Smith CA, Garber J, Walker LS (2013) Functional abdominal pain in childhood and long-term vulnerability to anxiety disorders. Pediatrics 132:475–482PubMedPubMedCentralCrossRef Shelby GD, Shirkey KC, Sherman AL, Beck JE, Haman K, Shears AR, Horst SN, Smith CA, Garber J, Walker LS (2013) Functional abdominal pain in childhood and long-term vulnerability to anxiety disorders. Pediatrics 132:475–482PubMedPubMedCentralCrossRef
Zurück zum Zitat Sleed M, Eccleston C, Beecham J, Knapp M, Jordan A (2005) The economic impact of chronic pain in adolescence: methodological considerations and a preliminary costs-of-illness study. Pain 119:183–190PubMedCrossRef Sleed M, Eccleston C, Beecham J, Knapp M, Jordan A (2005) The economic impact of chronic pain in adolescence: methodological considerations and a preliminary costs-of-illness study. Pain 119:183–190PubMedCrossRef
Zurück zum Zitat Stahlschmidt L, Zernikow B, Wager J (2016) Specialized rehabilitation programs for children and adolescents with severe disabling chronic pain: indications, treatment and outcomes. Children 3:33PubMedCentralCrossRef Stahlschmidt L, Zernikow B, Wager J (2016) Specialized rehabilitation programs for children and adolescents with severe disabling chronic pain: indications, treatment and outcomes. Children 3:33PubMedCentralCrossRef
Zurück zum Zitat Stahlschmidt L, Barth F, Zernikow B, Wager J (2017) Therapie-Outcome ein Jahr nach Erstvorstellung in einer pädiatrischen Schmerzambulanz – das Chronic Pain Grading (CPG) für jugendliche Schmerzpatienten. Schmerz 6:601–609CrossRef Stahlschmidt L, Barth F, Zernikow B, Wager J (2017) Therapie-Outcome ein Jahr nach Erstvorstellung in einer pädiatrischen Schmerzambulanz – das Chronic Pain Grading (CPG) für jugendliche Schmerzpatienten. Schmerz 6:601–609CrossRef
Zurück zum Zitat Stahlschmidt L, Zernikow B, Wager J (2018) Satisfaction with an intensive interdisciplinary pain treatment for children and adolescents: an independent outcome measure? Clin J Pain 34:795–803PubMed Stahlschmidt L, Zernikow B, Wager J (2018) Satisfaction with an intensive interdisciplinary pain treatment for children and adolescents: an independent outcome measure? Clin J Pain 34:795–803PubMed
Zurück zum Zitat Wager J, Zernikow B, Darlington AS, Vocks S, Hechler T (2014) Identifying subgroups of pediatric chronic pain patients: a cluster-analytic approach. Eur J Pain 18:1352–1362PubMedCrossRef Wager J, Zernikow B, Darlington AS, Vocks S, Hechler T (2014) Identifying subgroups of pediatric chronic pain patients: a cluster-analytic approach. Eur J Pain 18:1352–1362PubMedCrossRef
Zurück zum Zitat Walker LS, Dengler-Crish CM, Rippel S, Bruehl S (2010) Functional abdominal pain in childhood and adolescence increases risk for chronic pain in adulthood. Pain 150:568–572PubMedPubMedCentralCrossRef Walker LS, Dengler-Crish CM, Rippel S, Bruehl S (2010) Functional abdominal pain in childhood and adolescence increases risk for chronic pain in adulthood. Pain 150:568–572PubMedPubMedCentralCrossRef
Zurück zum Zitat Zernikow B, Ruhe A-K, Stahlschmidt L, Schmidt P, Staratzke T, Frosch M, Wager J (2018) Clinical and economic long-term treatment outcome of children and adolescents with disabling chronic pain. Pain Med 19:16–28PubMedCrossRef Zernikow B, Ruhe A-K, Stahlschmidt L, Schmidt P, Staratzke T, Frosch M, Wager J (2018) Clinical and economic long-term treatment outcome of children and adolescents with disabling chronic pain. Pain Med 19:16–28PubMedCrossRef
Metadaten
Titel
Wirksamkeit des Schmerztherapieprogramms
verfasst von
L. Stahlschmidt
M. Dobe
B. Zernikow
J. Wager
Copyright-Jahr
2019
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-58248-0_8

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