559 - Changes Over Three Months in Resilience Factors Among Youth with Chronic Musculoskeletal Pain and Their Caregivers Following Evaluation in an Interdisciplinary Pain Management Clinic

Poster Number: 559
Publication Number: 559.414

Background: We previously demonstrated that self-perceived resilience is low among youth with chronic musculoskeletal pain (CMP) at time of initial evaluation in a pediatric rheumatology subspecialty pain clinic. It is unclear, however, whether non-pharmacologic interdisciplinary care builds resilience in this patient population.

Objective: We aimed to compare patient and parental psychosocial factors and treatment outcomes at baseline vs first follow-up (3-months later) to understand whether resilience factors change with initiation of outpatient interdisciplinary care.

Design/Methods: This was a prospective, longitudinal survey study complemented by electronic medical record abstraction for patients aged 12-17 years newly diagnosed with CMP. Patients and their consented caregiver were administered electronic surveys, including demographics, patient-reported outcome (PRO) measures and self-reported psychosocial factors. Differences in PROs, resilience factors and other variables of interest at 3-months versus baseline were assessed with Wilcoxon signed rank test with continuity correction and Paired t-test as appropriate.

Results: 45 dyads completed the baseline and 3-month surveys and were included in the final analysis. Table 1 lists demographics and clinical characteristics of patients. Caregivers were all biological females, with a mean age of 48 (SD 5.4) years and were predominantly non-Hispanic (91%) White (82%). At 3-months, patients had fewer somatic complaints (p=0.04), more hope (p=0.03), greater pain-related self-efficacy (p=0.03) and less pain catastrophizing (p < 0.01) (Table 2). Self-reported psychological resilience among patients and caregivers did not change. Patients also demonstrated improvements in functional disability, overall health-related quality of life, pain intensity and pain interference (all p≤0.04; Table 3). However, anxiety, depression and psychological distress did not improve.

Conclusion(s): Within only 3-months of establishing care in a pediatric rheumatology subspeciality pain clinic, youth with CMP demonstrated improvements in several psychosocial factors and outcomes. Patient and caregiver self-perceived resilience did not change over the study interval. However, resilience is potentially modifiable and tools to improve resilience could facilitate accelerated improvements in multiple domains for children with CMP. Ongoing longitudinal data collection will enable assessment of durability of these findings and determine whether additional time is needed for resilience and mental health to improve with non-pharmacologic interdisciplinary care.