In This Section
Dr. Gmuca seeks to enhance the care of children with chronic musculoskeletal pain. Her current research addresses amplified musculoskeletal pain syndrome, which is a major public health issue because of its high prevalence, related socioeconomic burden, and associated risk of opioid exposure. Dr. Gmuca’s work aims to identify innovative strategies to improve long-term treatment outcomes for this patient population.
Dr. Gmuca is a pediatric rheumatologist, a faculty member of the Center for Pediatric Clinical Effectiveness and PolicyLab, and a physician with the Center for Amplified Musculoskeletal Pain Syndrome.
Her research aims to improve the treatment of pediatric chronic musculoskeletal pain, including amplified musculoskeletal pain syndrome and juvenile fibromyalgia syndrome (JFMS), in order to decrease the over-medicalization of these children and improve their long-term outcomes.
Her published research using national healthcare claims data demonstrated that approximately 20 percent of children with chronic musculoskeletal pain are exposed opioids, with about a quarter having experienced minor polypharmacy. Children seen by mental health or non-pharmacological providers were less likely to be opioid exposed. This work highlights the need for increased accessibility to non-pharmacological treatment interventions for this patient population.
Dr. Gmuca conducts ongoing research to evaluate measures of subjective and objective dyscognition among adolescents with JFMS. A significant number of teens report symptoms of brain fog but whether these symptoms are secondary to mental health issues, such as depression, or represent true neurocognitive impairment remains unknown. This work will help determine whether youth with JFMS would benefit from routine psychoeducational testing or if symptoms of brain fog are best treated with cognitive behavioral therapy.
She also investigates the use of healthcare claims data to examine the complications of extended antibiotic therapy for chronic Lyme disease as well as the misclassification of chronic musculoskeletal pain. Findings from this work will support future policy changes to eliminate the misuse of long-term antibiotics among children with chronic pain syndromes.
Dr. Gmuca’s latest research focuses on understanding the role of resilience in symptom severity and long-term outcomes in youth with chronic musculoskeletal pain. For this work, Dr. Gmuca has been awarded funding by the Rheumatology Research Foundation to further characterize psychosocial risk factors, including resilience, important in symptom severity and to pilot a resilience-training intervention in this patient population.
Dr. Gmuca’s career accomplishments to date include:
- Receiving the 2017 American College of Rheumatology Distinguished Fellow Award
- Receiving the 2017 CHOP Distinguished Research Trainee Award (Physician Fellow Category)
- Receiving the Thrasher Research Fund Early Career Award (2018)
- Receiving the Rheumatology Research Foundation K-Bridge Award (2019)
- Receiving the Rheumatology Research Foundation Investigator Award (2020)
Education and Training
BS, University of Rochester (Ecology and Evolutionary Biology), 2007
MD, State University of New York Downstate College of Medicine, 2011
Fellowship, Children's Hospital of Philadelphia (Rheumatology), 2017
MSCE, University of Pennsylvania (Clinical Epidemiology), 2018
Titles and Academic Titles
Instructor of Pediatrics
American College of Rheumatology, 2014-Present
Childhood Arthritis and Rheumatology Research Alliance, 2015- Present
Society of Pediatric Psychology, 2019-Present
International Association for the Study of Pain, 2019-Present
American College of Rheumatology Fellows in Training Travel Scholarship, 2015-2016
Rheumatology Research Foundation, Pediatric Research Award, 2016
CHOP Distinguished Research Trainee Award, 2017
Pediatric Rheumatology Symposium Fellows in Training Scholarship, 2017
Rheumatology Research Workshop Travel Award, 2017
American College of Rheumatology Distinguished Fellow Award, 2017
Rheumatology Research Foundation K-Bridge Award, 2019
Rheumatology Research Foundation Investigator Award, 2020