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P35 Pediatric practice patterns of the assessment and treatment of children and adolescents with medically unexplained symptoms – a danish national survey

Background Children and adolescents with medically unexplained symptoms (MUS) are commonly encountered in the pediatric setting. Still, clinical guidelines and systematic documentation of the content and extent of assessment and treatment of this patient group are lacking. Aim To explore practice patterns of the assessment and treatment of children and adolescents with MUS in the Danish pediatric setting. Method A de novo questionnaire with 60 questions was developed. This included questions about current treatment program, available resources, expectations for future patient volume and the experienced need for clinical guidelines. A qualified informant from each of the 19 pediatric departments was identified by the head of the department and invited to complete the questionnaire. Departments were categorized according to their quality of care, based on a multidisciplinary treatment program recommended in internal literature, by assessing the content of current treatment program as well as patterns of collaboration with CAMHS and other health sectors. The results were analyzed using descriptive statistics. Results All 19 pediatric departments participated. Among these, two had no available treatment program, 7 reported a less comprehensive, but still multidisciplinary program, and 10 reported a more comprehensive, multidisciplinary program. Eighteen respondents out of 19 (94%) expect a future increase in pediatric patients with MUS. Ten of 17 (59%) departments with established treatment reported a recent decrease in resources. Two thirds (67%) of the respondents express a need for clinical guidelines. Conclusion To the best of our knowledge, this is the first systematic study on the content and extent of care for patients with MUS in the pediatric setting. Substantial differences with regard to the quality of care to children and adolescents with MUS were observed. The trend of decreasing resources while expecting a future increase in the prevalence of children and adolescents with MUS within the health care system is worrisome. Developing clinical guidelines for assessment and treatment of children and adolescents with MUS, can potentially help to allocate resources and secure evidence-based care in the pediatric setting in general to this patient group.