E070 Lessons learned: developing a multidisciplinary group for paediatric chronic pain patients

Abstract

Background/Aims A multidisciplinary team (MDT) approach is best practice for managing chronic pain by supporting the psychological and physical challenges faced, including difficulty attending education and social isolation. However, with varying capacity among chronic pain specialists, treatment is often delayed. The group intervention model can support multiple patients more efficiently, while increasing understanding of pain and non-pharmacological interventions. Here, we share lessons learned in the development of a paediatric chronic pain group intervention. Methods The chronic pain service at Royal Manchester Children’s Hospital (RMCH) developed a face-to-face group intervention with psychology, physiotherapy, and occupational therapy approaches for patients (11-17 years old) and their parents. We explored attendance rates and family feedback given for not opting into the group and questionnaire responses from attendees following completion of the group. Professionals provided feedback during MDT meetings following the group. Results Parents/carers and patients identified barriers to attending the group as: taking time off work, patients missing education, childcare for siblings, travel distance to RMCH, difficulty attending the group due to pain, and patient anxiety around attending a face-to-face group. Professionals identified barriers of implementing the group as: limited space, variable attendance and/or attrition rates, limited staff support to help reduce attrition, and lack of funding for a more therapeutic space. It has also been difficult to capture longer term change and social benefits within the short time frame that the group takes place. In response to parent/carer and patient barriers, multiple formats of the group have been trialled. We have developed options to access a virtual group and a self-guided pain management pack for families unable to attend in person. We also provide a 1:1 pain management course for patients who are too anxious to attend the group. The face-to-face group format was also adapted to reduce the number of sessions requiring missed work or education and to allow use of pacing skills to manage pain. We have also observed several benefits of the group, including, providing families with introductory knowledge and skills around chronic pain management in a digestible way. We have observed connections made between patients and parents who can relate about their pain experiences. Further, professionals have expressed satisfaction with working cohesively to provide more comprehensive support to families. Conclusion Ultimately, given the complexity of this patient population, individualised work is typically required in addition to the group. However, we have found that group intervention has served well as a foundational support for patients with chronic pain. Finally, we have learned that there continue to be many gaps within paediatric chronic pain services, and we hope to develop more targeted services to increase access to foundational support earlier in patients’ care. However, this will require greater staff and resource capacity to do effectively. Disclosure D. Graham: None. M. Wheeler: None. C. Sergaki: None. H. Ronksley: None. T. Hutton: None.