Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100967804 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2431 (Electronic) Linking ISSN: 14712431 NLM ISO Abbreviation: BMC Pediatr Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Body Mass Index*; Pain/*epidemiology ; Pediatric Obesity/*epidemiology; Adolescent ; Age Distribution ; Child ; Child, Preschool ; Comorbidity ; Cross-Sectional Studies ; Female ; Humans ; Indiana/epidemiology ; Insurance Coverage ; Male ; Pediatric Obesity/ethnology ; Physical Examination ; Prevalence ; Primary Health Care ; Race Factors/statistics & numerical data ; Seasons ; Sex Distribution ; Social Class ; Young Adult

Background: Pediatric pain is associated to patient weight and demographics in specialized settings, but pain prevalence and its associated patient attributes in general pediatric outpatient care are unknown. Our objective was to determine the rate of positive pain screenings in pediatric primary care and evaluate the relationship between reported pain and obesity, demographics, and exam findings during routine pediatric encounters.
Methods: Cross-sectional observational study of 26,180 patients ages 2 to 19 seen in five urban pediatric primary care clinics between 2009 and 2016. Data were collected from systematic screening using a computerized clinical decision support system. Multivariable logistic regressions were used to analyze the association between pain reporting and obesity (body mass index), age, sex, race, season, insurance status, clinic site, prior pain reporting, pain reporting method, and exam findings.
Results: Pain was reported by the patient or caregiver in 14.9% of visits. In adjusted models, pain reporting was associated with obesity (Odds Ratio (OR) 1.23, 95% Confidence Intervals (CI) 1.11-1.35) and severe obesity (OR 1.32, CI 1.17-1.49); adolescents (OR 1.47, CI 1.33-1.61); and females (OR 1.21, CI 1.12-1.29). Pain reported at the preceding visit increased odds of pain reporting 2.67 times (CI 2.42-2.95). Abnormal abdominal, extremity, ear, nose, throat, and lymph node exams were associated with pain reporting. Pain reporting increased in minority races within clinics that predominantly saw a concordant race.
Conclusions: Pain is common in general pediatric encounters, and occurs more frequently in obese children and those who previously reported pain. Pain reporting may be influenced by seasonal variation and clinic factors. Future pediatric pain screening may be guided by associated risk factors to improve identification and targeted healthcare interventions.

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R01 HS020640 United States HS AHRQ HHS; R01 HS018453 United States HS AHRQ HHS; R01 DK092717 United States DK NIDDK NIH HHS; R01 HS017939 United States HS AHRQ HHS

Keywords: Ambulatory care; Clinical decision support; Obesity; Pain

Date Created: 20181123 Date Completed: 20191011 Latest Revision: 20191011

20231215

PMC6247700

10.1186/s12887-018-1335-0

30463543