Special populations 2


Chair: Harriet Wittink, Netherlands
Harriet Wittink, Netherlands
Children and adolescents
Jeanine Verbunt, Netherlands
Children and adolescents frequently complain about pain. Even up to 25% of schoolchildren, especially adolescents, report chronic pain. Musculoskeletal pain is, with headache and abdominal pain, one of the most reported pain complaints in adolescents. In about 10-30% of the children with pain, a specific medical disease is identified to explain the pain and in 40% pain will have a disabling impact on daily functioning. In those with chronic musculoskeletal pain, pain can have a huge impact on daily life activities. Pain can in addition interfere with developmental, school and leisure time activities, and causes serious psychological distress. To increase the quality of life and level of societal participation of children with disabling musculoskeletal pain, exposure in vivo treatment for children and their parents has been developed. In this presentation, exposure in vivo treatment for children/adolescents will be presented. We will address principles of this multidisciplinary team treatment and discuss treatment details like screening for treatment (including the application of the PHODA-youth), the content of the treatment program, the parent program, and results of a study on its effectiveness. We will in addition elaborate on the working-mechanism of exposure in vivo.
Older adults
Patricia Schofield, United Kingdom
The aim of the session is to explore the pharmacological interventions for the management of pain in the older population and to discuss the role of the nurse in the administration and monitoring of these interventions.


• Critically discuss the different types of analgesics and potential combinations
• Understand the principles of safe prescribing and administration considering the appropriateness of the prescription
• Prevent and manage common side effects and adverse events associated with pain treatment 

It is well documented that 40-80% of the older population have poorly controlled chronic pain. However, older adults present many challenges when it comes to prescribing drugs to manage pain. There are a number of factors which come into play. These include multiple co-morbidities such as frailty or cognitive impairment along with age associated changes which impact upon the kidneys and the liver which in turn impacts upon the metabolism of drugs. Furthermore, many older adults are often taking a combination of drugs which may interact against each other. Finally, older adults and health care professionals have fears and misconceptions regarding prescribing and administering in this population which prevents appropriate drug administration including fears of addiction and dependence.
Mental health
Laura Hemmings, United Kingdom
There is a complex, bidirectional link between pain and mental health which practitioners addressing patients with co-morbid pain and mental health diagnosis should be aware of. Within this session, we will explore how this relationship and resulting patient presentation impacts upon the approach of the physiotherapist in terms of assessment and treatment of pain. We will explore ways in which we should consider pain in this context, strategies to achieve this and the essential roles of the multi-disciplinary team and integrated pathways. With mental health conditions increasing in prevalence on a global scale, physiotherapists are likely to see a growing number of patients with complex, co-morbid physical and mental health needs. An awareness and understanding of these needs and how to address them is therefore deemed vital.

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