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Chronic Pain in Children and Adolescents: Economic Impact and Treatment Efficacy

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Chronic pain in children and adolescents (CPCA) is a growing concern due to its increasing prevalence and the considerable economic burden it places on patients, healthcare systems, and society. It is linked to a decline in quality of life and an increase in parental work loss. This burden has been evaluated through cost-of-illness studies (COIs) and the effectiveness of interventions through economic evaluations (EEs).

A comprehensive literature search was conducted in several databases including EMBASE, MEDLINE, PsycINFO, NHS EED, and HTA Database up to February 2023. Two researchers conducted the title, abstract, and full-text screening. Only original articles, published in English or German, that reported costs related to CPCA were considered. Information about the characteristics of the study, cost components, and costs were gathered. Standardized tools were used to assess the quality of the studies. All costs were converted to 2020 purchasing power parity US dollars (PPP-USD).

Chronic Pain

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The review included fifteen COIs and ten EEs. CPCA’s mean annual direct costs varied from PPP-USD 603 to PPP-USD 16,271, with outpatient services making up the largest portion. The mean annual indirect costs ranged from PPP-USD 92 to PPP-USD 12,721. Remarkably, all EEs reported decreased overall costs in patients who received treatment.

Despite the methodological heterogeneity across studies, which hinders comparability, the conclusion is clear. CPCA is associated with high overall costs, which were reduced in all EEs. From a health-economic perspective, efforts should be directed towards the prevention and early detection of CPCA, followed by specialized pain treatment.

 

Original Article DOI: 10.1097/AJP.0000000000001199

Original title: Cost-of-illness and Economic Evaluation of Interventions in Children and Adolescents with Chronic Pain: A Systematic Review

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