Peterson, Mark D (MD);O'Leary, Michael (M);Ashbaugh, Kathryn (K);Haapala, Heidi (H);Schmidt, Mary (M);Kamdar, Neil (N);Hurvitz, Edward A (EA);

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Mayo Clin Proc Innov Qual Outcomes.2025 Feb 19;9(2):100597.doi:10.1016/j.mayocpiqo.2025.100597

Abstract

OBJECTIVE: To examine the most common patterns of pain and symptom management strategies among adults living with cerebral palsy (CP), and to determine if there are differences by pain phenotype or co-occurring neurodevelopmental disorders.

PATIENTS AND METHODS: Federally insured beneficiaries were included if they had an ICD-9-CM/ICD-10-CM diagnosis code for CP (N=41,595). The study took place from January 10, 2024, to December 15, 2024. Medication and therapy prescription estimates for pain and CP symptom management were examined for the entire cohort, and between individuals with and without neurodevelopmental disorders and across pain phenotypes.

RESULTS: The most common pharmaceutical/nontherapy-based pain and symptom management interventions included high frequency prescriptions for antiepileptics (58%), antidepressants (49%), benzodiazepines (43%), nonsteroidal anti-inflammatories (43%), nonperioperative opioids (42%), antipsychotics (33%), muscle relaxants (31%), irritable bowel syndrome-specific drugs (20%), clonidine (12%), anticholinergics (11%), and botulinum toxin A injections (6%). Physical and occupational therapy were prescribed for 41% of the study cohort. Significant differences in treatment patterns were found for individuals with co-occurring neurodevelopmental disorders, and across pain phenotypes. Notably, for individuals with a mixed pain phenotype, nearly 80% were prescribed nonperioperative opioids.

CONCLUSION: Adults with CP have a high prescription prevalence of nonperioperative opioids and common nonopioid pain and symptom management.