Healthcare transition among young adults with childhood-onset chronic pain: A mixed methods study and proposed framework

Caitlin Murray, Lexa Murphy, Abbie Jordan, Michelle Owens, Dorothy McLeod, Tonya Palermo

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Chronic pain extends from childhood to adulthood for many young people. The transition from pediatric to adult care is a critical, yet understudied, healthcare task facing young adults with chronic pain. The aims of this observational, sequential mixed methods study were to 1) document the healthcare transition status of young adults with chronic pain (Stage 1, quantitative aim), 2) examine young adults’ perspectives of barriers and facilitators of healthcare transition (Stage 2, qualitative aim), and 3) integrate findings to construct a theoretical framework of healthcare transition. A cohort was identified with childhood chronic pain and prior care in one of 15 multidisciplinary pediatric pain clinics across the United States and Canada. Approximately 6 years later, 189 young adults (M age = 21.0; age range = 18–24; 81.5% female) from this cohort with continuing chronic pain completed surveys for Stage 1, and a subsample (n = 17) completed qualitative interviews for Stage 2. Quantitative findings demonstrated that young adults may experience lapses in care, with 41.8% indicating they had not transitioned to adult pain services. Qualitative analysis revealed young adults experienced significant barriers (eg, abrupt departure from pediatric care) as well as facilitators (eg, acceptance of pain prognosis) of healthcare transition. Quantitative and qualitative findings were integrated to construct a healthcare transition framework for chronic pain, which highlights transition as a complex process involving multiple pathways, outcomes, and stakeholders. Advancements in research and practice are needed to develop transition services to bridge gaps in care and optimize health outcomes for young people with chronic pain. Perspective: This mixed-methods study demonstrated that 41.8% of young adults with chronic pain experience lapses in adult-centered pain care and identified key barriers and facilitators to successful healthcare transition. Findings were integrated to construct the first healthcare transition framework for youth with chronic pain.

Original languageEnglish
Pages (from-to)1358-1370
Number of pages13
JournalJournal of Pain
Issue number8
Early online date14 Mar 2022
Publication statusPublished - 31 Aug 2022

Bibliographical note

Funding Information:
The research reported in this publication was supported by the National Institute of Child Health and Human Development under Award Number F32 HD097807 (PI: Caitlin Murray). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


  • Young adulthood
  • chronic pain
  • framework
  • healthcare transition

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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