The research gap in chronic paediatric pain: A systematic review of randomised controlled trials

R. Boulkedid; A. Y. Abdou; E. Desselas; M. Monégat; T. G. de Leeuw; J. Avez-Couturier; S. Dugue; C. Mareau; B. Charron; C. Alberti; F. Kaguelidou; Donjeta Bali; Alketa Hoxha(Qosja); Ermira Kola; Inga Talvik; Juliette Andrieu-Galien; Daniel Annequin; Romy Blanchet; Isabelle Desguerre; Elisabeth Fournier-Charrière; Barbara Tourniaire; Chantal Wood; Antje Neubert; Regina Trollmann; Stefan Wimmer; Eleana Garini; Panagoula Mammi; Marcello Allegretti; Ornella Bellagamba; Franca Benini; Donato Bonifazi; Daniela Caprino; Adriana Ceci; Sabrina Congedi; Francesco Craig; Sandro Dallorso; Antuan Divisic; Mariagrazia Felisi; Marco Gentile; Andrea De Giacomo; Rebecca Lundin; Luca Manfredini; Laura Mangiarini; Emilia Matera; Lucia Margari; Alessandro Mazza; Virgilio Pace; Chiara Di Pede; Maria Giuseppina Petruzzelli; Maarten O. Mensink

doi:10.1002/ejp.1137

The research gap in chronic paediatric pain: A systematic review of randomised controlled trials

R. Boulkedid, A. Y. Abdou, E. Desselas, M. Monégat, T. G. de Leeuw, J. Avez-Couturier, S. Dugue, C. Mareau, B. Charron, C. Alberti, F. Kaguelidou^*, Donjeta Bali, Alketa Hoxha(Qosja), Ermira Kola, Inga Talvik, Juliette Andrieu-Galien, Daniel Annequin, Romy Blanchet, Isabelle Desguerre, Elisabeth Fournier-CharrièreBarbara Tourniaire, Chantal Wood, Antje Neubert, Regina Trollmann, Stefan Wimmer, Eleana Garini, Panagoula Mammi, Marcello Allegretti, Ornella Bellagamba, Franca Benini, Donato Bonifazi, Daniela Caprino, Adriana Ceci, Sabrina Congedi, Francesco Craig, Sandro Dallorso, Antuan Divisic, Mariagrazia Felisi, Marco Gentile, Andrea De Giacomo, Rebecca Lundin, Luca Manfredini, Laura Mangiarini, Emilia Matera, Lucia Margari, Alessandro Mazza, Virgilio Pace, Chiara Di Pede, Maria Giuseppina Petruzzelli, Maarten O. Mensink,

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

2 Citations (Scopus)

Abstract

Background and Objective: Chronic pain is associated with significant functional and social impairment. The objective of this review was to assess the characteristics and quality of randomized controlled trials (RCTs) evaluating pain management interventions in children and adolescents with chronic pain. Methods: We performed a systematic search of PubMed, Embase and the Cochrane Library up to July 2017. We included RCTs that involved children and adolescents (3 months-18 years) and evaluated the use of pharmacological or non-pharmacological intervention(s) in the context of pain persisting or re-occurring for more than 3 months. Methodological quality was evaluated using the Cochrane Risk of Bias (ROB) Tool. Results: A total of 58 RCTs were identified and numbers steadily increased over time. The majority were conducted in single hospital institutions, with no information on study funding. Median sample size was 47.5 participants (Q1,Q3: 32, 70). Forty-five percent of RCTs included both adults and children and the median of the mean ages at inclusion was 12.9 years (Q1,Q3: 11, 15). Testing of non-pharmacological interventions was predominant and only 5 RCTs evaluated analgesics or co-analgesics. Abdominal pain, headache/migraine and musculoskeletal pain were the most common types of chronic pain among participants. Methodological quality was poor with 90% of RCTs presenting a high or unclear ROB. Conclusions: Evaluation of analgesics targeting chronic pain relief in children and adolescents through RCTs is marginal. Infants and children with long-lasting painful conditions are insufficiently represented in RCTs. We discuss possible research constraints and challenges as well as methodologies to circumvent them. Significance: There is a substantial research gap regarding analgesic interventions for children and adolescents with chronic pain. Most clinical trials in the field focus on the evaluation of non-pharmacological interventions and are of low methodological quality. There is also a specific lack of trials involving infants and children and adolescents with long-lasting diseases.

Original language	English
Pages (from-to)	261-271
Number of pages	11
Journal	European Journal of Pain (United Kingdom)
Volume	22
Issue number	2
DOIs	https://doi.org/10.1002/ejp.1137
Publication status	Published - 1 Feb 2018

Access to Document

10.1002/ejp.1137

Cite this

Boulkedid, R., Abdou, A. Y., Desselas, E., Monégat, M., de Leeuw, T. G., Avez-Couturier, J., Dugue, S., Mareau, C., Charron, B., Alberti, C., Kaguelidou, F., Bali, D., Hoxha(Qosja), A., Kola, E., Talvik, I., Andrieu-Galien, J., Annequin, D., Blanchet, R., Desguerre, I. (2018). The research gap in chronic paediatric pain: A systematic review of randomised controlled trials. European Journal of Pain (United Kingdom), 22(2), 261-271. https://doi.org/10.1002/ejp.1137

@article{c003534ce3544b438fc2bdd376feffd8,

title = "The research gap in chronic paediatric pain: A systematic review of randomised controlled trials",

abstract = "Background and Objective: Chronic pain is associated with significant functional and social impairment. The objective of this review was to assess the characteristics and quality of randomized controlled trials (RCTs) evaluating pain management interventions in children and adolescents with chronic pain. Methods: We performed a systematic search of PubMed, Embase and the Cochrane Library up to July 2017. We included RCTs that involved children and adolescents (3 months-18 years) and evaluated the use of pharmacological or non-pharmacological intervention(s) in the context of pain persisting or re-occurring for more than 3 months. Methodological quality was evaluated using the Cochrane Risk of Bias (ROB) Tool. Results: A total of 58 RCTs were identified and numbers steadily increased over time. The majority were conducted in single hospital institutions, with no information on study funding. Median sample size was 47.5 participants (Q1,Q3: 32, 70). Forty-five percent of RCTs included both adults and children and the median of the mean ages at inclusion was 12.9 years (Q1,Q3: 11, 15). Testing of non-pharmacological interventions was predominant and only 5 RCTs evaluated analgesics or co-analgesics. Abdominal pain, headache/migraine and musculoskeletal pain were the most common types of chronic pain among participants. Methodological quality was poor with 90% of RCTs presenting a high or unclear ROB. Conclusions: Evaluation of analgesics targeting chronic pain relief in children and adolescents through RCTs is marginal. Infants and children with long-lasting painful conditions are insufficiently represented in RCTs. We discuss possible research constraints and challenges as well as methodologies to circumvent them. Significance: There is a substantial research gap regarding analgesic interventions for children and adolescents with chronic pain. Most clinical trials in the field focus on the evaluation of non-pharmacological interventions and are of low methodological quality. There is also a specific lack of trials involving infants and children and adolescents with long-lasting diseases.",

author = "R. Boulkedid and Abdou, {A. Y.} and E. Desselas and M. Mon{\'e}gat and {de Leeuw}, {T. G.} and J. Avez-Couturier and S. Dugue and C. Mareau and B. Charron and C. Alberti and F. Kaguelidou and Donjeta Bali and Alketa Hoxha(Qosja) and Ermira Kola and Inga Talvik and Juliette Andrieu-Galien and Daniel Annequin and Romy Blanchet and Isabelle Desguerre and Elisabeth Fournier-Charri{\`e}re and Barbara Tourniaire and Chantal Wood and Antje Neubert and Regina Trollmann and Stefan Wimmer and Eleana Garini and Panagoula Mammi and Marcello Allegretti and Ornella Bellagamba and Franca Benini and Donato Bonifazi and Daniela Caprino and Adriana Ceci and Sabrina Congedi and Francesco Craig and Sandro Dallorso and Antuan Divisic and Mariagrazia Felisi and Marco Gentile and {De Giacomo}, Andrea and Rebecca Lundin and Luca Manfredini and Laura Mangiarini and Emilia Matera and Lucia Margari and Alessandro Mazza and Virgilio Pace and {Di Pede}, Chiara and {Giuseppina Petruzzelli}, Maria and Mensink, {Maarten O.}",

year = "2018",

month = feb,

day = "1",

doi = "10.1002/ejp.1137",

language = "English",

volume = "22",

pages = "261--271",

journal = "European Journal of Pain (United Kingdom)",

issn = "1090-3801",

publisher = "John Wiley & Sons Inc.",

number = "2",

}

Boulkedid, R, Abdou, AY, Desselas, E, Monégat, M, de Leeuw, TG, Avez-Couturier, J, Dugue, S, Mareau, C, Charron, B, Alberti, C, Kaguelidou, F, Bali, D, Hoxha(Qosja), A, Kola, E, Talvik, I, Andrieu-Galien, J, Annequin, D, Blanchet, R, Desguerre, I, Fournier-Charrière, E, Tourniaire, B, Wood, C, Neubert, A, Trollmann, R, Wimmer, S, Garini, E, Mammi, P, Allegretti, M, Bellagamba, O, Benini, F, Bonifazi, D, Caprino, D, Ceci, A, Congedi, S, Craig, F, Dallorso, S, Divisic, A, Felisi, M, Gentile, M, De Giacomo, A, Lundin, R, Manfredini, L, Mangiarini, L, Matera, E, Margari, L, Mazza, A, Pace, V, Di Pede, C, Giuseppina Petruzzelli, M, Mensink, MO 2018, 'The research gap in chronic paediatric pain: A systematic review of randomised controlled trials', European Journal of Pain (United Kingdom), vol. 22, no. 2, pp. 261-271. https://doi.org/10.1002/ejp.1137

TY - JOUR

T1 - The research gap in chronic paediatric pain

T2 - A systematic review of randomised controlled trials

AU - Boulkedid, R.

AU - Abdou, A. Y.

AU - Desselas, E.

AU - Monégat, M.

AU - de Leeuw, T. G.

AU - Avez-Couturier, J.

AU - Dugue, S.

AU - Mareau, C.

AU - Charron, B.

AU - Alberti, C.

AU - Kaguelidou, F.

AU - Bali, Donjeta

AU - Hoxha(Qosja), Alketa

AU - Kola, Ermira

AU - Talvik, Inga

AU - Andrieu-Galien, Juliette

AU - Annequin, Daniel

AU - Blanchet, Romy

AU - Desguerre, Isabelle

AU - Fournier-Charrière, Elisabeth

AU - Tourniaire, Barbara

AU - Wood, Chantal

AU - Neubert, Antje

AU - Trollmann, Regina

AU - Wimmer, Stefan

AU - Garini, Eleana

AU - Mammi, Panagoula

AU - Allegretti, Marcello

AU - Bellagamba, Ornella

AU - Benini, Franca

AU - Bonifazi, Donato

AU - Caprino, Daniela

AU - Ceci, Adriana

AU - Congedi, Sabrina

AU - Craig, Francesco

AU - Dallorso, Sandro

AU - Divisic, Antuan

AU - Felisi, Mariagrazia

AU - Gentile, Marco

AU - De Giacomo, Andrea

AU - Lundin, Rebecca

AU - Manfredini, Luca

AU - Mangiarini, Laura

AU - Matera, Emilia

AU - Margari, Lucia

AU - Mazza, Alessandro

AU - Pace, Virgilio

AU - Di Pede, Chiara

AU - Giuseppina Petruzzelli, Maria

AU - Mensink, Maarten O.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background and Objective: Chronic pain is associated with significant functional and social impairment. The objective of this review was to assess the characteristics and quality of randomized controlled trials (RCTs) evaluating pain management interventions in children and adolescents with chronic pain. Methods: We performed a systematic search of PubMed, Embase and the Cochrane Library up to July 2017. We included RCTs that involved children and adolescents (3 months-18 years) and evaluated the use of pharmacological or non-pharmacological intervention(s) in the context of pain persisting or re-occurring for more than 3 months. Methodological quality was evaluated using the Cochrane Risk of Bias (ROB) Tool. Results: A total of 58 RCTs were identified and numbers steadily increased over time. The majority were conducted in single hospital institutions, with no information on study funding. Median sample size was 47.5 participants (Q1,Q3: 32, 70). Forty-five percent of RCTs included both adults and children and the median of the mean ages at inclusion was 12.9 years (Q1,Q3: 11, 15). Testing of non-pharmacological interventions was predominant and only 5 RCTs evaluated analgesics or co-analgesics. Abdominal pain, headache/migraine and musculoskeletal pain were the most common types of chronic pain among participants. Methodological quality was poor with 90% of RCTs presenting a high or unclear ROB. Conclusions: Evaluation of analgesics targeting chronic pain relief in children and adolescents through RCTs is marginal. Infants and children with long-lasting painful conditions are insufficiently represented in RCTs. We discuss possible research constraints and challenges as well as methodologies to circumvent them. Significance: There is a substantial research gap regarding analgesic interventions for children and adolescents with chronic pain. Most clinical trials in the field focus on the evaluation of non-pharmacological interventions and are of low methodological quality. There is also a specific lack of trials involving infants and children and adolescents with long-lasting diseases.

AB - Background and Objective: Chronic pain is associated with significant functional and social impairment. The objective of this review was to assess the characteristics and quality of randomized controlled trials (RCTs) evaluating pain management interventions in children and adolescents with chronic pain. Methods: We performed a systematic search of PubMed, Embase and the Cochrane Library up to July 2017. We included RCTs that involved children and adolescents (3 months-18 years) and evaluated the use of pharmacological or non-pharmacological intervention(s) in the context of pain persisting or re-occurring for more than 3 months. Methodological quality was evaluated using the Cochrane Risk of Bias (ROB) Tool. Results: A total of 58 RCTs were identified and numbers steadily increased over time. The majority were conducted in single hospital institutions, with no information on study funding. Median sample size was 47.5 participants (Q1,Q3: 32, 70). Forty-five percent of RCTs included both adults and children and the median of the mean ages at inclusion was 12.9 years (Q1,Q3: 11, 15). Testing of non-pharmacological interventions was predominant and only 5 RCTs evaluated analgesics or co-analgesics. Abdominal pain, headache/migraine and musculoskeletal pain were the most common types of chronic pain among participants. Methodological quality was poor with 90% of RCTs presenting a high or unclear ROB. Conclusions: Evaluation of analgesics targeting chronic pain relief in children and adolescents through RCTs is marginal. Infants and children with long-lasting painful conditions are insufficiently represented in RCTs. We discuss possible research constraints and challenges as well as methodologies to circumvent them. Significance: There is a substantial research gap regarding analgesic interventions for children and adolescents with chronic pain. Most clinical trials in the field focus on the evaluation of non-pharmacological interventions and are of low methodological quality. There is also a specific lack of trials involving infants and children and adolescents with long-lasting diseases.

UR - http://www.scopus.com/inward/record.url?scp=85032915408&partnerID=8YFLogxK

U2 - 10.1002/ejp.1137

DO - 10.1002/ejp.1137

M3 - Review article

AN - SCOPUS:85032915408

SN - 1090-3801

VL - 22

SP - 261

EP - 271

JO - European Journal of Pain (United Kingdom)

JF - European Journal of Pain (United Kingdom)

IS - 2

ER -

The research gap in chronic paediatric pain: A systematic review of randomised controlled trials

Abstract

Access to Document

Other files and links

Fingerprint

Cite this