Pain, mental health and healthcare utilization: Impact of the COVID-19 pandemic on youth with chronic pain, parents and siblings

Sabine Soltani; Tieghan Killackey; Kathryn A Birnie; Sarah Brennenstuhl; Daniel C Kopala-Sibley; Manon Choiniere; M Gabrielle Pagé; Lise Dassieu; Anaïs Lacasse; Chitra Lalloo; Patricia Poulin; Pablo Ingelmo; Samina Ali; Marco Battaglia; Fiona Campbell; Andrew Smith; Myles Benayon; Isabel Jordan; Justina Marianayagam; Lauren Harris; Vina Mohabir; Jennifer Stinson; Melanie Noel; COVIDChildPain Team

doi:10.1002/ejp.2157

Pain, mental health and healthcare utilization: Impact of the COVID-19 pandemic on youth with chronic pain, parents and siblings

Eur J Pain. 2023 Nov;27(10):1249-1265. doi: 10.1002/ejp.2157. Epub 2023 Jul 12.

Authors

Sabine Soltani¹, Tieghan Killackey², Kathryn A Birnie^{3

4}, Sarah Brennenstuhl⁵, Daniel C Kopala-Sibley^{6

7}, Manon Choiniere^{8

9}, M Gabrielle Pagé^{8

10}, Lise Dassieu^{9

11}, Anaïs Lacasse¹², Chitra Lalloo^{2

13}, Patricia Poulin^{14

15

16}, Pablo Ingelmo¹⁷, Samina Ali^{18

19}, Marco Battaglia^{20

21}, Fiona Campbell²², Andrew Smith²³, Myles Benayon²⁴, Isabel Jordan²⁵, Justina Marianayagam²⁶, Lauren Harris², Vina Mohabir², Jennifer Stinson^{2

5}, Melanie Noel^{7

27}; COVIDChildPain Team

Affiliations

¹ Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
² Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
³ Department of Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, Alberta, Canada.
⁴ Department of Community Health Sciences, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
⁵ Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
⁶ Department of Psychiatry, University of Calgary, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
⁷ Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada.
⁸ Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
⁹ Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
¹⁰ Department of Psychology, Research Center of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
¹¹ Department of Biomedical Sciences, Université de Montréal, Montreal, Quebec, Canada.
¹² Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Quebec, Canada.
¹³ Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁵ Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Canada.
¹⁶ The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
¹⁷ Anesthesia and Chronic Pain Management, Montreal Children's Hospital, Montreal, Quebec, Canada.
¹⁸ Departments of Pediatrics & Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
¹⁹ Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada.
²⁰ Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
²¹ CYEA Programme, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
²² Department of Anesthesia and Pain Medicine, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada.
²³ Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
²⁴ Internal Medicine Residency Program, McMaster University, Hamilton, Ontario, Canada.
²⁵ Parent Partner, British Columbia, Squamish, Canada.
²⁶ Northern Ontario School of Medicine, Sudbury, Ontario, Canada.
²⁷ Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.

PMID: 37435883
DOI: 10.1002/ejp.2157

Abstract

Background: Paediatric chronic pain was a public health emergency before the novel coronavirus (COVID-19) pandemic, and this problem is predicted to escalate. Pain tends to occur intergenerationally in families, and youth with chronic pain and their parents have high rates of mental health issues, which can further exacerbate pain. Siblings of youth with chronic pain have been largely overlooked in research, as well as the impact of the pandemic on posttraumatic stress disorder (PTSD) symptoms and healthcare utilization.

Methods: This cross-sectional study examined pain, mental health and healthcare utilization in three groups: youth with chronic pain (n = 357), parents of youth with chronic pain (n = 233) and siblings of youth with chronic pain (n = 156) during the COVID-19 pandemic in Canada.

Results: More so than with pain symptoms, the results revealed high levels of mental health symptoms (i.e. anxiety, depressive, and PTSD), particularly in individuals more personally impacted by the pandemic. The largest effect was seen on PTSD symptoms for all groups. For parents with chronic pain, greater personal COVID-19 impact was related to worse pain interference. Reported rates of healthcare utilization were strikingly high, with youth with chronic pain, parents (reporting on behalf of their children with chronic pain), and siblings of youth with chronic pain reporting that most consultations were due to pain.

Conclusions: Longitudinal research assessing these outcomes across continued waves of the pandemic is needed to ensure timely, tailored and equitable access to pain and mental health assessment and treatment.

Significance: This study examined pain, mental health, substance use and healthcare utilization in youth with chronic pain, siblings and parents during the COVID-19 pandemic. Greater personal impact of the pandemic was not largely associated with poorer pain outcomes; however, it was associated with mental health, with the largest effect on PTSD symptoms. The high rates and significant association of COVID-19 impact with PTSD symptoms underscore the importance of including PTSD assessment as part of routine screening practices in pain clinics.

Pain, mental health and healthcare utilization: Impact of the COVID-19 pandemic on youth with chronic pain, parents and siblings

Authors

Collaborators

Affiliations

Abstract

Grants and funding