Outcome Assessment in Children and Adolescents With Chronic Pain: An International Clinical Practice Survey

Abstract

Background: Effective treatment of paediatric chronic pain requires a robust and comprehensive set of outcome assessment tools to evaluate treatment effectiveness. Although a core outcome set (COS) exists for clinical trials, its practicability and appropriateness for clinical practice is currently unknown. This cross-sectional study led by the IN-ChildPain group aimed to: (1) identify clinical outcome domains and measures used by clinicians treating children and adolescents with chronic pain, (2) determine which domains are considered mandatory in clinical routine and (3) compare prioritisation across disciplines and countries. Methods: An online survey, available in eight languages, was conducted eliciting data from clinicians who treat children and adolescents with chronic pain. Percentages of the most commonly used outcomes were calculated, and z-tests were performed to compare study variables based on participants' country income status and professional background. Results: A total of 193 clinicians from 42 countries participated. The most commonly assessed domains were pain intensity (84%), pain interference (80%) and physical functioning (79%), with higher assessment rates in high-income countries. Pain intensity and interference were deemed mandatory by 93% of participants, followed by physical functioning (92%). However, only 53% reported using patient-reported outcome measures, with the 0–10 Numeric Rating Scale being the most common (94%). Assessment practices varied as a function of country income level and professional background. Conclusions: The findings highlight the need to develop and implement a COS tailored to the needs and resources of clinicians. Such standardisation would enhance consistency in assessment, enable cross-site benchmarking and promote equitable pain care globally. Significance: This study provides critical insights into how clinicians assess paediatric chronic pain, highlighting significant global disparities and professional differences in outcome domain prioritisation. By identifying commonly assessed domains, these findings emphasise the need for standardised measures and pave the way for developing a core outcome set tailored to clinical activities. Such an advance is essential for improving the consistency and quality of care for children and adolescents with chronic pain worldwide.