Dr Christine Lamontagne is a pediatric anesthesiologist, pain physician and clinical researcher at the Children’s Hospital of Eastern Ontario. She is the Medical Director of the Chronic Pain Services where she has lead the creation of an interdisciplinary chronic pain service. She has Co-Chaired the development of the Ontario Pediatric Chronic Pain Network in partnership with the Ontario Ministry of Health and continues to work at improving access to interdisciplinary chronic pain care for all children. She has developed national recognition for research in acute and chronic pain as collaborator on the CIHR funded strategy for Patient Oriented Research (SPOR) Chronic Pain Network (CPN). Her current research focus is in the area of pediatric pain prevention and management and includes:
(1) Utilizing quality improvement methodology to improve pain outcomes for chronic pain patients navigating the current health care system through patient engagement and transition to adult care (2) Identifying strategies to improve acute pain management in order to prevent the development of chronic pain by addressing one of the major risk factor: pain catastrophizing (3) Evaluating the role of different approaches (physical, psychological and pharmacological) in improving pain outcomes for chronic pain patients treated in an interdisciplinary context through the use of online resources and workshops. 4) Estimating the incidence of pediatric Complex Regional Pain Syndrome, describe the pain trajectories and evaluate best therapeutic approaches.
Research Projects
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Impacting the physical activity confidence of children with medical conditions or disabilities: A randomized controlled trial
27/03/2025
Youth with medical conditions or disabilities (MCD) seldom achieve healthy physical activity recommendations. Barriers include a perceived lack of competence, fear of pain/symptom exacerbation, or physical function changes. A 12-week intervention targeting physical activity confidence was evaluated among youth with MCD. The study found that youth who were confident were more likely to engage in physical activity. The in-person intervention increased participants’ activity confidence. The limited impact of the virtual format suggests that implementing new skills with peers is critically important for enhancing activity confidence. Further research is required to evaluate whether confidence gains could be sustained beyond the study intervention, would longitudinally increase activity participation over time, or would transfer to other activity settings.
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Virtual psychoeducation for improvement of pain catastrophizing in pediatric presurgical patients and caregivers: A proof-of-concept study
03/10/2024
Youth (n = 43) and caregivers (n = 41) attended a virtual, group-based single-session intervention (SSI). Single-session intervention content addressed pain neuroscience, PC, and adaptive coping strategies for managing pain and PC drawn from cognitive-behavioural, acceptance and commitment, and dialectical behaviour therapy approaches. Participants completed questionnaires assessing PC at preintervention, postintervention, and two weeks postsurgery. Youth mood and anxiety were assessed at preintervention.
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Triage Decision-Making in Interdisciplinary Pediatric Chronic Pain Programs
10/04/2024
Pediatric chronic pain is considered a significant problem worldwide (Tutelman et al., 2021). Chronic pain in children and adolescents not only increases risk of mobility issues, significant fatigue, poor sleep, school absenteeism, decreased cognitive function, and worsening mental health (Miro et al., 2022), but also increases risk for opioid misuse in youth (Pielech et al., 2020). Interdisciplinary pediatric chronic pain programs are the gold standard for the treatment of chronic pain (Law et al., 2013); however the limited number of programs (Caes et al., 2018) may contribute to prolonged wait times. Lengthy wait times to access pain care in children and adolescents have been linked to increased frustration, anxiety, and feelings of hopelessness (Palermo et al., 2019). Because of the variability in complexity and disability between pediatric chronic pain patients (Wagner et al., 2013), it is essential to optimize triage decisions to chronic pain programs to accurately prioritize pain care for patients in highest need. Still there is no established model or framework for this purpose.
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A systematic review of the biopsychosocial dimensions affected by chronic pain in children and adolescents: identifying reliable and valid pediatric multidimensional chronic pain assessment tools
12/01/2023
Pediatric chronic pain is a complex experience that is often challenging to describe and measure. Multidimensional tools that evaluate the biopsychosocial impact of chronic pain in pediatric patients can help clinicians to prioritize and tailor interdisciplinary pain care; yet, the psychometric value and clinical utility of such tools has not yet been systematically studied in the literature. The purpose of this review was to identify multidimensional biopsychosocial tools used in pediatric chronic pain, synthesize their reliability and validity evidence, and draw on this evidence to describe the relationships between chronic pain and biopsychosocial domains. The search involved 2 phases to (1) identify eligible tools and (2) conduct a measured forward citation search of tool development articles. Tool eligibility was guided by the Multidimensional Biobehavioral Model of Pediatric Pain and study eligibility was focused on primary chronic pain diagnoses unrelated to disease. Data extraction was focused on reliability and validity evidence of eligible tools, guided by the Standards for Educational and Psychological Testing. Results yielded 6 tools that included 64 eligible studies, highlighting 84 significant relationships between pain and functional interference across 11 biopsychosocial variables. All tools were shown to have good internal consistency and evidence of validity, primarily through relationships to other variables. Of the 6 tools, the most brief and easy to use were the most under studied. Further psychometric research is warranted for these tools to investigate their clinical utility and psychometric properties in guiding and prioritizing pain care for children and adolescents.
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Attaining expert consensus on diagnostic expectations of primary chronic pain diagnoses for patients referred to interdisciplinary pediatric chronic pain programs: A delphi study with pediatric chronic pain physicians and advanced practice nurses
09/01/2022
Pediatric primary chronic pain disorders come with diagnostic uncertainty, which may obscure diagnostic expectations for referring providers and the decision to accept or re-direct patients into interdisciplinary pediatric chronic pain programs based on diagnostic completeness. This study aimed to attain expert consensus on diagnostic expectations for patients who are referred to interdisciplinary pediatric chronic pain programs with six common primary chronic pain diagnoses. This study demonstrated a general agreement amongst pediatric chronic pain experts regarding diagnostic expectations of patients referred to interdisciplinary chronic pain programs with primary chronic pain diagnoses. Study findings may help to clarify referral expectations and the decision to accept or re-direct patients into such programs based on diagnostic completeness while reducing the occurrence of unnecessary diagnostic tests and subsequent delays in accessing specialized care.