A Lifespan Approach towards Paediatric Pain Management: from Neonates to Young Adults

Abstract

First paragraph: Given the interdisciplinary nature of paediatric pain management, especially in the case of chronic pain, continuity and personalisation of care is key to ensure that families can engage with and navigate such complex healthcare systems, involving multiple stakeholders and various transitions across the lifespan, as smoothly as possible (1). The World Health Organisation (WHO) defines continuity of care as “the degree to which a series of discrete health care events is experienced by people as coherent and interconnected over time and consistent with their health needs and preferences” (2). Personalised, continuity of care has many benefits such as reducing healthcare costs, hospital admissions, emergency care visits, and increased satisfaction with care (2, 3). A recent scoping review on continuity of care within paediatric chronic illnesses (including chronic pain conditions) (1) developed a process model of high-quality care coordination in paediatric patients, characterisizing high-quality care coordination by (1) setting clear responsibilities, (2) effective and reliable communication between professionals as well as with caregivers, (3) formalized, written care coordination plans, (4) flexible and child-centred care through building trust and relationships, and (5) involvement of community-based structures (e.g., schools). However, a key issue with continuity of care is that it is often threatened or broken when a young person transitions into adult care (4). While a consensus on successful transition outcomes is lacking, optimal transition should not only support better engagement and satisfaction with pain management services but also improve well-being and attainment of relevant vocational and social milestones (4). There is an urgent need to better understand this transition process and ensure that the continuity and personalisation of care stretches across paediatric and adult healthcare settings, which a lifespan approach would bring.