Bridget Farrant

The New Zealand Medical Journal (NZMJ) is the principal scientific journal for the medical profession in New Zealand. The Journal has become a fundamental resource for providing research and written pieces from the health and medical industry.

Aim: To report the prevalence of self‐reported chronic pain and severity among young people in New Zealand and explore the relationships between pain and mental health, substance use, socialisation and school engagement.Methods: Prevalence of self‐reported chronic pain frequency and severity are reported from an anonymous, representative cross‐sectional self‐administered health and well‐being questionnaire by students aged 12–18 years in New Zealand. Multivariable models exploring chronic pain and mental health, substance use, socialisation and school engagement are reported controlling for age, sex, ethnicity, socio‐economic status, disability and history of sexual abuse.Results: Overall, 22.8% (95% confidence interval (CI) 21.2–24.5) of young people reported chronic pain for 6 months or more, with 3.2% (95% CI 3.1–4.5) reporting severe pain weekly or more often. Females and rural adolescents were more likely to report chronic and severe pain. Asian youth reported less pain than other ethnic groups. Increased severity of pain was associated more with poorer daily functioning and socialising than with frequency of pain. Severe pain occurring weekly or more often was more common among students who had a disability (2.3% 95% CI 1.8–2.7 vs. 9.8%, 95% CI 7.2–12.5) or a history of sexual abuse (2.4% 95% 1.9–2.9 vs. 8.5%, 95% CI 6.3–10.5). Those reporting chronic pain had higher proportions of self‐reported significant depressive symptoms, lower well‐being, lower school engagement and lower access to health care, particularly for those reporting higher levels of intensity and frequency of pain.Conclusions: Chronic pain is common in adolescent populations, and has a significant association with decreased daily functioning, socialising, school engagement and mental well‐being. Adolescents with chronic pain report significant unmet health‐care needs.

Aim: To determine whether the transfer of young people with cystic fibrosis (CF) or bronchiectasis from paediatric to adult services is associated with changes in service engagement and/or health outcomes.Methods: Young people aged ≥15 years of age with CF or bronchiectasis who transferred from the Auckland‐based paediatric service (Starship Children's Hospital) to one of three Auckland‐based District Health Boards between 2005 and 2012 were identified and included if they had 3 years care both pre‐transfer and post‐transfer care. Transfer preparation, service engagement (clinics scheduled, clinics attended) and health outcomes (lung function, hospitalisations) were collected per annum.Results: Fifty‐seven young people transferred in this period with 46 meeting inclusion criteria (CF n = 20, bronchiectasis n = 26). The CF group had better transfer documentation, were transferred at an older age (11 months older P < 0.0001 95%CI: 6.7 months, 14.7 months), were 20 times more likely to attend clinics (P < 0.0001, 95%CI: 7.8, 66.1) and had 3–4 more clinics scheduled pre‐transfer (P < 0.0001, 95%CI: 3.4, 4.9) and post‐transfer (P < 0.0001, 95%CI: 2.4, 3.8) despite having less severe respiratory disease as measured by FEV1 for each year (P < 0.01, 95%CI: 0.34, 1.22).Conclusion: The transfer of young people with CF to adult services did not affect health engagement or outcomes, in contrast to those with bronchiectasis. Use of a formalised transfer process, more clinic appointments offered and greater resources for CF may be responsible for this difference. Comprehensive transition with purposeful, planned movement and developmentally appropriate care is a key goal.