Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain Conditions
The evidence supporting the use of pharmacological treatments in pediatric chronic pain is limited. Quantitative sensory testing (QST) and conditioned pain modulation evaluation (CPM) provide information on pain phenotype, which may help clinicians to tailor the treatment. This retrospective study a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/8/1157 |
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| author | Alice Bruneau Catherine E. Ferland Rafael Pérez-Medina-Carballo Marta Somaini Nada Mohamed Michele Curatolo Jean A. Ouellet Pablo Ingelmo |
| author_facet | Alice Bruneau Catherine E. Ferland Rafael Pérez-Medina-Carballo Marta Somaini Nada Mohamed Michele Curatolo Jean A. Ouellet Pablo Ingelmo |
| author_sort | Alice Bruneau |
| collection | DOAJ |
| description | The evidence supporting the use of pharmacological treatments in pediatric chronic pain is limited. Quantitative sensory testing (QST) and conditioned pain modulation evaluation (CPM) provide information on pain phenotype, which may help clinicians to tailor the treatment. This retrospective study aimed to evaluate the association between the use of QST/CPM phenotyping on the selection of the treatment for children with chronic pain conditions. We retrospectively analyzed the medical records of 208 female patients (mean age 15 ± 2 years) enrolled in an outpatient interdisciplinary pediatric complex pain center. Pain phenotype information (QST/CPM) of 106 patients was available to the prescribing physician. The records of 102 age- and sex-matched patients without QST/CPM were used as controls. The primary endpoint was the proportion of medications and interventions prescribed. The secondary endpoint was the duration of treatment. The QST/CPM group received less opioids (7% vs. 28%, respectively, <i>p</i> < 0.001), less anticonvulsants (6% vs. 25%, <i>p</i> < 0.001), and less interventional treatments (29% vs. 44%, <i>p</i> = 0.03) than controls. Patients with an optimal CPM result tended to be prescribed fewer antidepressants (2% vs. 18%, <i>p</i> = 0.01), and patients with signs of allodynia and/or temporal summation tended to be prescribed fewer NSAIDs (57% vs. 78%, <i>p</i> = 0.04). There was no difference in the duration of the treatments between the groups. QST/CPM testing appears to provide more targeted therapeutic options resulting in the overall drop in polypharmacy and reduced use of interventional treatments while remaining at least as effective as the standard of care. |
| first_indexed | 2024-03-09T13:39:47Z |
| format | Article |
| id | doaj.art-cfffe1d1a84e4bbe86133e2360064b25 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T13:39:47Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-cfffe1d1a84e4bbe86133e2360064b252023-11-30T21:08:22ZengMDPI AGChildren2227-90672022-08-0198115710.3390/children9081157Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain ConditionsAlice Bruneau0Catherine E. Ferland1Rafael Pérez-Medina-Carballo2Marta Somaini3Nada Mohamed4Michele Curatolo5Jean A. Ouellet6Pablo Ingelmo7Division of Experimental Medicine, McGill University, Montreal, QC H3A 0G4, CanadaDepartment of orthopedic surgery, Shriners Hospitals for Children-Canada, Montreal, QC H4A 0A9, CanadaIntegrated Program in Neurosciences, McGill University, Montreal, QC H3A 0G4, CanadaEdwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC H4A 3J1, CanadaEdwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC H4A 3J1, CanadaDepartment of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98195, USADepartment of orthopedic surgery, Shriners Hospitals for Children-Canada, Montreal, QC H4A 0A9, CanadaEdwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC H4A 3J1, CanadaThe evidence supporting the use of pharmacological treatments in pediatric chronic pain is limited. Quantitative sensory testing (QST) and conditioned pain modulation evaluation (CPM) provide information on pain phenotype, which may help clinicians to tailor the treatment. This retrospective study aimed to evaluate the association between the use of QST/CPM phenotyping on the selection of the treatment for children with chronic pain conditions. We retrospectively analyzed the medical records of 208 female patients (mean age 15 ± 2 years) enrolled in an outpatient interdisciplinary pediatric complex pain center. Pain phenotype information (QST/CPM) of 106 patients was available to the prescribing physician. The records of 102 age- and sex-matched patients without QST/CPM were used as controls. The primary endpoint was the proportion of medications and interventions prescribed. The secondary endpoint was the duration of treatment. The QST/CPM group received less opioids (7% vs. 28%, respectively, <i>p</i> < 0.001), less anticonvulsants (6% vs. 25%, <i>p</i> < 0.001), and less interventional treatments (29% vs. 44%, <i>p</i> = 0.03) than controls. Patients with an optimal CPM result tended to be prescribed fewer antidepressants (2% vs. 18%, <i>p</i> = 0.01), and patients with signs of allodynia and/or temporal summation tended to be prescribed fewer NSAIDs (57% vs. 78%, <i>p</i> = 0.04). There was no difference in the duration of the treatments between the groups. QST/CPM testing appears to provide more targeted therapeutic options resulting in the overall drop in polypharmacy and reduced use of interventional treatments while remaining at least as effective as the standard of care.https://www.mdpi.com/2227-9067/9/8/1157quantitative sensory testingconditioned pain modulationchronic painpharmacotherapy |
| spellingShingle | Alice Bruneau Catherine E. Ferland Rafael Pérez-Medina-Carballo Marta Somaini Nada Mohamed Michele Curatolo Jean A. Ouellet Pablo Ingelmo Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain Conditions Children quantitative sensory testing conditioned pain modulation chronic pain pharmacotherapy |
| title | Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain Conditions |
| title_full | Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain Conditions |
| title_fullStr | Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain Conditions |
| title_full_unstemmed | Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain Conditions |
| title_short | Association between the Use of Quantitative Sensory Testing and Conditioned Pain Modulation and the Prescription of Medication and Interventional Procedures in Children with Chronic Pain Conditions |
| title_sort | association between the use of quantitative sensory testing and conditioned pain modulation and the prescription of medication and interventional procedures in children with chronic pain conditions |
| topic | quantitative sensory testing conditioned pain modulation chronic pain pharmacotherapy |
| url | https://www.mdpi.com/2227-9067/9/8/1157 |
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