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Tachdjian R, Kaplan AP. A Comprehensive Management Approach in Pediatric and Adolescent Patients With Hereditary Angioedema. Clin Pediatr (Phila) 2023; 62:973-980. [PMID: 36908071 PMCID: PMC10478326 DOI: 10.1177/00099228231155703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Hereditary angioedema (HAE) is a rare autosomal-dominant disorder; most cases are characterized by low plasma levels of C1 esterase inhibitor (C1-INH). Clinical manifestations of HAE due to C1-INH deficiency include unpredictable, acute, recurrent episodes of nonpruritic swelling that can affect the face, trunk, limbs, and the respiratory, gastrointestinal, and genitourinary tracts. Attacks can be disfiguring, disabling, painful, and even life-threatening if laryngeal swelling occurs. Symptoms of HAE generally manifest in childhood. Effective medications are available and approved to treat HAE in children. However, evidence informing use of these medications in pediatric clinical practice is limited. Hereditary angioedema management plans are critical to optimize outcomes and should address on-demand treatment for acute attacks and plans to prevent potentially fatal laryngeal attacks. The plan should also comprise a holistic approach to address nonclinical aspects of HAE, including quality of life (QoL) and psychological issues. This article provides an overview of HAE management principles that health care providers can apply to treat pediatric patients to improve their QoL.
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Affiliation(s)
- Raffi Tachdjian
- UCLA School of Medicine, Los Angeles, CA, USA
- Division of Allergy and Immunology, Providence St. John Medical Center, Santa Monica, CA, USA
| | - Allen P. Kaplan
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Allergy and Clinical Immunology, Medical University of South Carolina, Charleston, SC, USA
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Goren K, Cen Y, Montemurri V, Moodley D, Sutton A, Ahmed A, Alphonsus L, Denezis P, Fleming C, Guertin H, Hyland K, Kalim A, Kim HH, Krause S, Liang A, Maclean E, Neocleous P, Patel A, Pritchard S, Purcell V, Qaqish M, Ryall S, Shum K, Suwary K, Vucetic A, Skinner J, Woolsey A, Marcotte E. The impact of music, play, and pet therapies in managing pain and anxiety in paediatric patients in hospital: a rapid systematic review. Paediatr Child Health 2023; 28:218-224. [PMID: 37287483 PMCID: PMC10243982 DOI: 10.1093/pch/pxad010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/29/2023] [Indexed: 06/09/2023] Open
Abstract
Background Hospitalized children face pain and anxiety associated with the environment and procedures. Objective This review aimed to assess the impact of music, play, pet and art therapies on pain and anxiety in hospitalized paediatric patients. RCTs assessing the impact of music, play, pet, and/or art therapies on pain and/or anxiety in hospitalized paediatric patients were eligible. Methods Database searching and citation screening was completed to identify studies. A narrative synthesis was used to summarize study findings and certainty of evidence was assessed using GRADE. Of the 761 documents identified, 29 were included spanning music (n = 15), play (n = 12), and pet (n = 3) therapies. Results A high certainty of evidence supported play in reducing pain and moderate certainty for music and pet. A moderate certainty of evidence supported music and play in reducing anxiety. Conclusion Complementary therapies utilized alongside conventional medical treatment may mitigate pain and anxiety in hospitalized paediatric patients.
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Affiliation(s)
- Katherine Goren
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Yuchen Cen
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Vanessa Montemurri
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Dirusha Moodley
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Arielle Sutton
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Alveena Ahmed
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Lotus Alphonsus
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Peter Denezis
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Courtney Fleming
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Hailey Guertin
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Kiley Hyland
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Ayesha Kalim
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Harry Hyunteh Kim
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Sarah Krause
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Aileen Liang
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Eleanor Maclean
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Penelope Neocleous
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Arjun Patel
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Sharon Pritchard
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Victoria Purcell
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Michael Qaqish
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Stephanie Ryall
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Kathryn Shum
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Kylie Suwary
- Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
| | - Andrea Vucetic
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Jamila Skinner
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Amadene Woolsey
- Schulich School of Medicine and Dentistry, Western University, London, Ontario
| | - Emily Marcotte
- Department of Paediatrics, Schulich School of Medicine and Dentistry, University of Windsor, Windsor, Ontario
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Stegemann T, Geretsegger M, Phan Quoc E, Riedl H, Smetana M. Music Therapy and Other Music-Based Interventions in Pediatric Health Care: An Overview. MEDICINES 2019; 6:medicines6010025. [PMID: 30769834 PMCID: PMC6473587 DOI: 10.3390/medicines6010025] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/01/2019] [Accepted: 02/11/2019] [Indexed: 01/08/2023]
Abstract
Background: In pediatric health care, non-pharmacological interventions such as music therapy have promising potential to complement traditional medical treatment options in order to facilitate recovery and well-being. Music therapy and other music-based interventions are increasingly applied in the clinical treatment of children and adolescents in many countries world-wide. The purpose of this overview is to examine the evidence regarding the effectiveness of music therapy and other music-based interventions as applied in pediatric health care. Methods: Surveying recent literature and summarizing findings from systematic reviews, this overview covers selected fields of application in pediatric health care (autism spectrum disorder; disability; epilepsy; mental health; neonatal care; neurorehabilitation; pain, anxiety and stress in medical procedures; pediatric oncology and palliative care) and discusses the effectiveness of music interventions in these areas. Results: Findings show that there is a growing body of evidence regarding the beneficial effects of music therapy, music medicine, and other music-based interventions for children and adolescents, although more rigorous research is still needed. The highest quality of evidence for the positive effects of music therapy is available in the fields of autism spectrum disorder and neonatal care. Conclusions: Music therapy can be considered a safe and generally well-accepted intervention in pediatric health care to alleviate symptoms and improve quality of life. As an individualized intervention that is typically provided in a person-centered way, music therapy is usually easy to implement into clinical practices. However, it is important to note that to exploit the potential of music therapy in an optimal way, specialized academic and clinical training and careful selection of intervention techniques to fit the needs of the client are essential.
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Affiliation(s)
- Thomas Stegemann
- Department of Music Therapy, University of Music and Performing Arts Vienna, 1030 Vienna, Austria.
- WZMF-Music Therapy Research Centre Vienna, University of Music and Performing Arts Vienna, 1010 Vienna, Austria.
| | - Monika Geretsegger
- GAMUT-The Grieg Academy Music Therapy Research Centre, NORCE, 5008 Bergen, Norway.
| | - Eva Phan Quoc
- WZMF-Music Therapy Research Centre Vienna, University of Music and Performing Arts Vienna, 1010 Vienna, Austria.
| | - Hannah Riedl
- WZMF-Music Therapy Research Centre Vienna, University of Music and Performing Arts Vienna, 1010 Vienna, Austria.
| | - Monika Smetana
- Department of Music Therapy, University of Music and Performing Arts Vienna, 1030 Vienna, Austria.
- WZMF-Music Therapy Research Centre Vienna, University of Music and Performing Arts Vienna, 1010 Vienna, Austria.
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