Transition of Care Readiness Among Adolescents with Chronic Pain Between 2021-2022 in a Nationally Representative Sample

Abstract

Chronic pain impacts 11-33% of children and will continue into adulthood for over half of them.Transition of pain management to adult care is crucial given high risk of interruption of care which is associated with subsequent poor medical, social, and vocational outcomes. Yet the transition experience for these youth is poorly characterized. We aimed to determine the prevalence of transition readiness among adolescents with chronic pain in the U.S. and estimate the association of readiness with biopsychosocial-cultural and health system characteristics. 2,584 adolescents age 14-17 with chronic pain were identified by parent report in the 2021 and 2022 National Survey of Children's Health. Poisson regression was used to identify characteristics associated with readiness. 23.9% of adolescents met criteria for transition readiness. Those more likely to meet criteria were older (PR 1.8 95%CI: 1.3, 2.6), female (PR 1.6 95% CI: 1.2, 2.2), White (Asian PR 0.4, 95% CI: 0.2, 0.9, Multi-racial PR 0.6 95% CI: 0.4, 0.9), and experienced shared decision making (aPR 1.7 95% CI: 1.1, 2.8). Fewer than half met criteria for medical home, effective care coordination, and adequate insurance. This study is an important first step in demonstrating low transition readiness among adolescents with chronic pain and identifying healthcare continuity concerns. Future research should incorporate adolescents and provider perspectives and investigate pain specific factors relevant to transition readiness and investigate how readiness relates to transition outcomes.