Evidence map›Paper›PMID 34570203›Full record

Trial reportJAMA network open2021

Effectiveness of a Psychosocial Aftercare Program for Youth Aged 8 to 17 Years With Severe Chronic Pain: A Randomized Clinical Trial.

Meltem Dogan, Gerrit Hirschfeld, Markus Blankenburg, Michael Frühwald, Rosemarie Ahnert, Sarah Braun, Ursula Marschall, Ingo Pfenning, Boris Zernikow, Julia Wager

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in JAMA network open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

Meltem DoganGerman Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.
Gerrit HirschfeldFaculty of Business and Health, University of Applied Sciences Bielefeld, Bielefeld, Germany.
Markus BlankenburgGerman Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.
Michael FrühwaldUniversity Children's Hospital Augsburg, Swabian Children's Pain Center, Augsburg, Germany.
Rosemarie AhnertUniversity Children's Hospital Augsburg, Swabian Children's Pain Center, Augsburg, Germany.
Sarah BraunPaediatric Pain Center Baden-Württemberg, Department of Pediatric Neurology, Olgahospital Stuttgart, Stuttgart, Germany.
Ursula MarschallDepartment of Medicine and Health Services Research, BARMER Health Insurance, Wuppertal, Germany.
Ingo PfenningTechniker Krankenkasse, Techniker Health Insurance, Hamburg, Germany.
Boris ZernikowGerman Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.
Julia WagerGerman Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany.
Olgahospital · DEUniversity Hospital Augsburg · DEWitten/Herdecke University · DEBARMER GEK · DEGerman Center for Pediatric and Adolescent Rheumatology · DEHochschule Bielefeld · DETechniker Krankenkasse (Germany) · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Severe chronic pediatric pain causes individual suffering and significantly affects social functioning and psychological well-being. For children with high pain severity, intensive interdisciplinary pain treatment (IIPT) is a well-established treatment. However, across specialized centers, it is not sufficient for all patients. Objective: To evaluate the effectiveness of a psychosocial aftercare (PAC) program for pediatric patients with severe chronic pain followed up for 6 months after discharge from IIPT. Design, Setting, and Participants: This multicenter randomized clinical trial with 4 assessment points (pre-IIPT, immediately post-IIPT, 3 months, and 6 months) was conducted at 3 pediatric specialized tertiary care pain centers in Germany between September 11, 2018, and March 31, 2020. Included patients were aged 8 to 17 with a severe chronic pain condition who had been admitted for IIPT. Data were analyzed from June 8 to September 4, 2020. Interventions: Patients and their families were randomly assigned to 1 of 2 study groups at inpatient IIPT admission. Both groups received standardized 3- to 4-week IIPT. After IIPT discharge, the intervention group received PAC and the control group received usual care. PAC involved ongoing contact with a social worker for as long as the family requested the support, up to a maximum of 6 months. Main Outcomes and Measures: The primary outcome measure was pain at 6 months, measured using the Chronic Pain Grading (CPG), an instrument based on an algorithm indicating severity of the chronic pain disorder. Secondary outcomes included other pain-related and emotional parameters. Results: A total of 419 patients were randomized (mean [SD] age, 14.3 [2.1] years; 303 [72.3%] girls; 116 [27.7%] boys), with 218 assigned to usual care and 201 assigned to PAC. At baseline in both groups, the median (IQR) CPG was 3 (2-4). Superiority of PAC compared with usual care was demonstrated at 6 months (median [IQR] CPG: usual care, 2 [2-3]; PAC, 1 [1-2]; r = 0.30; 95% CI, 0.17-0.41). Additionally, PAC significantly improved emotional parameters (eg, significant time × group interaction: b = -8.84; P < .001). Conclusions and relevance: This randomized clinical trial found that PAC improved pain-related and emotional parameters during the intervention 6 months after discharge from IIPT. Future research is needed to investigate the intervention's long-term effects. Trial Registration: German Clinical Trials Register ID: DRKS00015230.

Indexed as

AdolescentAftercareAnxietyChildChronic PainDepressionFemaleGermanyHumansMalePain MeasurementPatient SatisfactionTreatment Outcome

Identifiers

PMID34570203
PMCPMC8477265
OpenAlexW3201883436

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.