325: Paediatric Intensive Interdisciplinary Pain Management Programme: Content, Outcome, Randomised Trial

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Non-pharmacological treatments, Treatment/management , Pain in special populations (e.g. neonates, children, teens, elderly, neurodegenerative diseases)

Background and Aims: For adolescents with chronic pain and significant pain-related disability, family-focussed paediatric intensive interdisciplinary pain management programmes (PIIPMP) can: improve emotional, physical and family function; support shifts to self-management of pain; enhance progress toward developmentally appropriate goals; and reduce healthcare costs. However, the strength of evidence varies across studies.(1-4)
Aims:
- describe development of a PIIPMP integrated into Chronic Pain Clinic pathways at Great Ormond Street Hospital (GOSH);
- report data covering recommended mandatory, important and research outcome domains for paediatric chronic pain trials (5) at baseline, completion of PIIPMP and follow-up;
- discuss progress and feasibility of randomised trial with longterm follow-up.

Methods: An interdisciplinary standardised 3-week PIIPMP incorporating group and individual sessions for adolescents (11-18yrs) and their parent/carer was developed. Evaluations at programme beginning, end, and follow-up included: patient- and parent-reported questionnaires; physical assessments; health economics; and intervention outcomes (treatment fidelity, attendance, satisfaction, adverse events).
Participants were recruited from GOSH Pain Clinic. Following a soft launch period (June 2024-Dec 2025; GOSH Audit No:3903), eligible and consenting participants were randomised to Early PMP (within 1-3 months) or usual Pain Clinic outpatient care until Delayed PMP (6-9 months)(PIIPeR-Feasibility Trial; Ethics ID:24/LO/0680 Approval 29/9/24; Protocol: www.isrctn.com/ISRCTN91641999).

Results: Soft Launch: Forty-three adolescents (12-17yrs) and parents reported significant and clinically meaningful improvements in patient- and parent-reported outcomes (quality of life, emotional distress, pain catastrophizing, fear of pain, pain acceptance, stages of change, pain interference) and adolescent physical function improved from baseline to PIIPMP completion, with maintainenance at 3-month follow-up.
PIIPeR Trial: Of 78 new pain clinic assessments, 43 aged 11-18 years fulfilled 3 of 4 eligibility criteria (reduced quality of life; high pain catastrophizing; reduced school attendance; high emotional distress and/or reduced mobility/strength). 73% (31/43) consented/assented to the randomised trial. Updated data will be presented.

Conclusions: - The GOSH PIIPMP improved psychosocial, physical, and family function for adolescents with chronic pain-related disability.
- Attendance and engagement of parents was an essential component.
- Collection of recommended core outcomes was feasible and acceptable to participants.
- Evaluation of treatment fidelity was enhanced by close integration of clinical and research teams.
- Successful development of the PIIPMP required an interdisciplinary team with experience in paediatric pain management (nurse practitioner, clinical psychologist, occupational therapist, physiotherapist, pain clinician, pain researcher), and delivery required recruitment and training of additional staff.
- Collaboration with GOSH Chronic Pain Clinic staff facilitated integration with current care pathways.

References: 1. Claus BB et al. Intensive interdisciplinary pain treatment for children and adolescents with chronic noncancer pain: systematic review. Pain 2022;163(12):2281-301.
2. Hurtubise K et al. Comparison of Intensive Interdisciplinary Pain Treatment and Multimodal Treatment for Youths With Pain-related Disability. Clin J Pain 2020;36(11):833-44.
3. Randall ET et al. Long-term Functional Status of Pediatric Patients Who Completed Intensive Interdisciplinary Pain Treatment. Clin J Pain 2018;34(10):890-9.
4. Lopez Lumbi S et al Economic long-term effects of intensive interdisciplinary pain treatment for paediatric patients with severe chronic pain. Eur J Pain 2021;25(10):2129-39.
5. Palermo TM et al. Core outcome set for pediatric chronic pain clinical trials. Pain 2021;162(10):2539-47

Presenting Author: Suellen Walker
Submitting Author: Suellen Walker

Senior Author: Suellen Walker

IASP 2026 Global Year theme of Neuropathic Pain: No

• Anna Fieldwalker: PhD - Great Ormond Street Hospital
• Judy Peters: MSc - Great Ormond Street Hospital
• Hummingbird Unit Team - Great Ormond Street Hospital