Background and aims 
Persons with multiple disability and handicap often suffer from many conditions, including chronic or acute pain. Because limited communication skills, the diagnosis is often underestimated and analgesic management is often difficult. A number of scales have been validated in persons with impaired communications or with intellectual disability. 
Methods
The DHIADEM project (Douleur Handicap IAtrogénie DEnutrition Médicament) is a project supported by the French Health Agency. Its main objective is to explore knowledge on pain evaluation of healthcare professionals in 15 centers for disabled persons.
Results
The preliminary data reveal a paucity of pain assessment and a poor use of observational pain scales. Health professionals reported that pain assessment was mostly based on their own judgment in daily care with non-communicating residents. Further data are being collected and full results expected in June 2019.
Conclusion 
These preliminary results highlight the lack of knowledge and suggest the importance of training healthcare professionals to pain assessment and management in people with disability, in order to limit inequalities of care in vulnerable people.

PAIN ASSESSMENT IN DISABLED ADULTS: A FEW MISSING PIECES IN THE JIGSAW