Adherence Behaviors in Youth Following the Completion of an Intensive Interdisciplinary Pain Rehabilitation Program

Abstract

Chronic pain in youth is increasing and there is limited research regarding adherence behaviors in this population. As treatment is commonly an interdisciplinary approach involving a combination of medical, psychological, and physical treatments, it is important to understand how youth adhere to multiple treatment recommendations. Limited research suggests that adherence for youth with chronic pain is variable and often dependent on the type of recommendation. The current study evaluated adherence behaviors for youth following completion of an intensive interdisciplinary pain treatment (IIPT) program at one-month, six-month, and 12-month follow up appointments. Data collection included a retrospective medical record review of 122 patients with chronic pain who had completed the IIPT program. Results indicated variable levels of adherence for youth with highest rates occurring for recommendations related to exercise and counseling participation. Lowest adherence rates were reported for self-regulation recommendations. Overall adherence rates were found to be statistically different between one-month (M=6.23; SD=1.68) and six-month (M=5.21; SD=1.89) follow up appointments (p=0.001) with lower adherence at six-month follow up. Functional disability, quality of life, and pain intensity were not significantly correlated with adherence rates at any follow up appointments. Depression, anxiety, pain acceptance, pain interference, and insurance type were not found to predict adherence rates at one-month follow up appointments. This study provides initial information regarding adherence for youth following completion of an IIPT program as well as providing longitudinal adherence information over the first year following program completion. Continued research is needed in order to generalize findings. Formalized assessment of adherence should be incorporated in future research.