Optimising the integrated management of children and young people with persistent pain

Phil Nixon1

1Project ECHO®, Integrated Care, Children’s Health Queensland Hospital and Health Service, South Brisbane, Australia


Persistent pain in children and young people is common, with reported prevalence rates ranging from 11 to 38%.1 Persistent pain and associated disability is most effectively managed with a sociopsychobiomedical approach, ideally, in the patient’s local community. However, it can be challenging for regional and remote clinicians to manage these complex patients.

Project ECHO® is a model of inter-professional education delivered via videoconference, which seamlessly integrates advice from multiple disciplines in the support and mentoring of care providers.2 ECHO® improves access to services and enhances clinician capacity to deliver best-practice care to patients in their local communities.


Series one of Children’s Health Queensland Hospital and Health Service’s paediatric persistent pain ECHO® was completed in 2018. Descriptive data was collected including number of participants, their disciplines, and geographical locations. Qualitative data was collected using an on-line questionnaire including feedback on syllabus content, case-based discussions and recommendations, and on perceived knowledge and confidence before and after the series.


35 participants were registered for series one, from the following disciplines: General Paediatrics, Occupational Therapy, Physiotherapy, Psychology, Social Work, Music Therapy, and Nursing. Participants attended from a mix of community and hospital-based settings, across South-East and North Queensland. Questionnaire feedback indicated that participants valued the opportunity for networking and knowledge sharing.


Our ECHO® series is the first in the world dedicated to childhood persistent pain. Early feedback is promising. It is anticipated that engaging clinicians through ECHO® on a state-wide level will improve transfer of knowledge, and foster relationships between clinicians, with the ultimate aim of improving persistent pain services for children and young people in their local communities. A second series has been launched to a national and international audience, with the hope of promoting a consistent message of pain understanding and sociopsychobiomedical treatment approaches.


1 King S et al. (2011). The epidemiology of chronic pain in children and adolescents revisited: A systematic review. Pain 152 (12) 2729-2738.

2 University of New Mexico (2018). About Project ECHO®. Retrieved from the University of New Mexico website: https://echo.unm.edu/about-echo/model/


Phil has a background in physiotherapy in the area of acute paediatrics. He has practiced clinically at both Mater Children’s and Queensland Children’s Hospitals, predominantly in the areas of orthopaedics and clinical education. Phil has a special interest in making quality health care accessible for families in under-resourced areas.

Phil’s current role in the Children’s Health Queensland Integrated Care team involves clinical engagement with Project ECHO® stakeholders, including participants, panel teams, and partners of the hub.

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