Dedicated multidisciplinary pain management centres for children in Canada: the current status (original) (raw)

Abstract

Purpose: The objective of this study was to examine the services currently offered by multidisciplinary pain treatment facilities (MPTFs) dedicated for pediatric chronic pain management across Canada.

Methods: A MPTF was defined as a clinic that advertised specialized multidisciplinary services for the diagnosis and management of chronic pain and had a minimum of three different health care disciplines (including at least one medical speciality) available and integrated within the facility. The search method was previously described in an accompanying article. Designated investigators were responsible for confirming and supplementing MPTFs from the preliminary list in their respective provinces. Administrative leads at each eligible MPTF were asked to complete a detailed questionnaire on their infrastructure, clinical, research, teaching and administrative activities. Only MPTFs dedicated to pediatric populations were included.

Results: Only five centres surveyed had dedicated pediatric MPTFs, all located in major cities in five different provinces. While the median wait time was four weeks, it could be as long as nine months in one MPTF. Headache and neuropathic pain were the most commonly treated pain syndromes. All MPTFs included physicians, nurses and psychologists, and used a rehabilitation model that incorporated a wide variety of pharmacological, psychological and physical therapies. All centres provided training for medical and other healthcare professionals, and three of the five centres conducted research. Government funding was the major source of funding for patient services and overhead costs.

Conclusions: There are very few pediatric MPTFs in Canada. These facilities exist in five of ten provinces, each within large urban centres. Limited accessibility leads to variable and prolonged wait times for pediatric patients suffering from chronic pain.

Résumé

Objectif: L’objectif de cette étude était d’examiner les services actuellement offerts par les établissements pluridisciplinaires de traitement de la douleur (MPTF — multidisciplinary pain treatment facility) spécialisés dans la prise en charge des douleurs chroniques chez les enfants au Canada.

Méthode: Un MPTF a été défini comme une clinique affichant des services pluridisciplinaires spécialisés pour le diagnostic et la prise en charge des patients souffrant de douleurs chroniques, et possédant au moins trois disciplines différentes de soins de santé (y compris au moins une spécialité médicale) à disposition et intégrées dans l’établissement. La méthode de recherche a été précédemment décrite dans un article concomitant. Des chercheurs désignés étaient responsables de la confirmation et de l’ajout de MPTF à la liste préliminaire dans leur province respective. On a demandé à la direction administrative de chaque MPTF éligible de remplir un questionnaire détaillé concernant l’infrastructure de son MPTF ainsi que ses activités de soins, de recherche, d’enseignement et de gestion. Seuls les MPTF se consacrant aux enfants ont été inclus.

Résultats: Seulement cinq des centres contactés offraient des MPTF pédiatriques spécialisés, tous situés dans des grandes villes de cinq provinces différentes. Bien que le temps d’attente médian soit de quatre semaines, il pouvait aller jusqu’à neuf mois dans un des établissements. Les maux de tête et les douleurs neuropathiques constituaient les syndromes de la douleur les plus fréquemment soignés. Tous les MPTF comptaient des médecins, des infirmiers, infirmières et psychologues, et utilisaient un modèle de réhabilitation qui comprenait une grande diversité de traitements pharmacologiques, psychologiques et physiques. Tous ces centres fournissent une formation pour les professionnels médicaux et de la santé, et il existait de la recherche dans trois des cinq établissements. Le financement public constituait la source la plus importante de financement pour les services aux patients et pour les frais généraux.

Conclusion: Il n’existe que très peu d’établissements pluridisciplinaires de traitement de la douleur spécialisés en pédiatrie au Canada. Ces centres existent dans cinq des dix provinces, et tous se trouvent dans des centres urbains d’envergure. Un accès limité engendre des temps d’attente variables et prolongés pour les enfants souffrant de douleurs chroniques.

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Authors and Affiliations

1. From the Wasser Pain Management Centre, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
   Philip Peng MD
2. the Faculty of Nursing, University of Toronto, The Hospital for Sick Children, Toronto, Ontario
   Jennifer N. Stinson PhD
3. the Department of Anesthesia, Montreal Heart Institute, Faculty of Medicine, University of Montreal, Montreal, Quebec
   Manon Choiniere PhD
4. the Department of Family Medicine, Hôpital Maisonneuve-Rosemont, Faculty of Medicine, University of Montreal, Montreal, Quebec
   Dominique Dion MD MSc
5. the Health Science Centre Pain Clinic, Winnipeg, Manitoba
   Howard Intrater FRCPC
6. the School of Nursing, Memorial University, St. John’s, Newfoundland
   Sandra LeFort PhD
7. the Pain Management Unit, Queen Elizabeth II Health Centre, Halifax, Nova Scotia
   Mary Lynch FRCPC
8. St Paul’s Hospital, Vancouver, British Columbia
   May Ong FRCPC
9. the Multidisciplinary Pain Centre, University of Alberta Hospital, Edmonton, Alberta
   Saifee Rashiq MSc (Epid) DA (UK) FRCPC
10. the Chronic Pain Centre, Saskatoon Health Region, Saskatoon, Saskatchewan
    Yves Veillette FRCPC
11. the Department of Anesthesia, Clinique Anti-douleur, Hôpital Maisonneuve-Rosemont, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
    Sandra LeFort PhD

Authors

1. Philip Peng MD
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2. Jennifer N. Stinson PhD
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3. Manon Choiniere PhD
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4. Dominique Dion MD MSc
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5. Howard Intrater FRCPC
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6. Sandra LeFort PhD
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7. Mary Lynch FRCPC
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8. May Ong FRCPC
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9. Saifee Rashiq MSc (Epid) DA (UK) FRCPC
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10. Gregg Tkachuk PhD
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11. Yves Veillette FRCPC
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STOPPAIN Investigators Group

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Correspondence toPhilip Peng MD.

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Competing interest: None declared.

Funding: The study was funded by the Canadian Institutes of Health Research (via the CIHR/Rx&D Collaborative Research Program) in partnership with Pfizer Canada and the three networks of the Fonds de la recherche en santé du Québec (Santé buccodentaire, Adaption-réadaption, Neurosciences et santé mentale).

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Peng, P., Stinson, J.N., Choiniere, M. et al. Dedicated multidisciplinary pain management centres for children in Canada: the current status.Can J Anesth 54, 985–991 (2007). https://doi.org/10.1007/BF03016632

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• Accepted: 03 September 2007
• Issue Date: December 2007
• DOI: https://doi.org/10.1007/BF03016632

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