Consolidation, Systematic Appraisal and Comparison of Guideline Recommendations Regarding Management of Chronic Pain: Protocol for a Digital Chronic Pain Recommendation Map

ABSTRACT Introduction Chronic pain affects 1 in 5 adults and children globally; however, management remains highly variable and low value care is common. Inconsistent recommendations among clinical practice guidelines for management of chronic pain contribute to suboptimal patient management. We will develop and disseminate a living digital chronic pain recommendation map (e‐Chronic Pain RecMap) to identify trustworthy recommendations in three high priority areas, (1) opioids, (2) cannabis for medical purposes, and (3) spine‐related interventional procedures for chronic pain. Methods The project comprises three phases. A planning phase to engage a diverse group of interest holders to co‐design a team structure with our knowledge users to ensure an efficient and effective workflow. Through a search of electronic databases and a manual search of international websites, a development phase to systematically identify relevant guidelines published in any language since 2019. In this development phase, we will update our searches every 6 months. Also, we will appraise the reporting quality of eligible guidelines using the AGREE‐II instrument, followed by appraisal of recommendation‐level quality using AGREE‐REX for guidelines meeting a defined threshold. In a next step, we will extract data from guidelines including relevant equity information using infrastructure in GRADEPro, and explore divergence and compare recommendations answering the same guideline question. Lastly, we will develop plain language summaries of trustworthy recommendations and decision aids to support patient‐physician decision making, and translate the platform to French, Spanish, and Mandarin. Finally, a mobilization phase in which, with our interest holders, we will co‐create strategies to disseminate the RecMap to relevant target users. Discussion The Chronic Pain RecMap will enhance use of trustworthy guideline recommendations by people living with chronic pain, clinicians, and decision makers. Successful uptake will optimize evidence‐based pain management.

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Publication Details

Journal
Clinical and Public Health Guidelines
Published
2025-08-11
DOI
https://doi.org/10.1002/gin2.70033
Citations
1
Primary Topic
Clinical practice guidelines implementation
Type
article
Field-Weighted Citation Impact
1.88

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article

Consolidation, Systematic Appraisal and Comparison of Guideline Recommendations Regarding Management of Chronic Pain: Protocol for a Digital Chronic Pain Recommendation Map

Vivian Welch, Iván D. Flórez, Gonzalo Bravo‐Soto, Stacey A. Ritz et al.
1 citations
Clinical and Public Health Guidelines
Clinical practice guidelines implementation
1.88
article

Consolidation, Systematic Appraisal and Comparison of Guideline Recommendations Regarding Management of Chronic Pain: Protocol for a Digital Chronic Pain Recommendation Map

Vivian Welch, Iván D. Flórez, Gonzalo Bravo‐Soto, Stacey A. Ritz, Jason Walter Busse, Lynn Cooper, Holger J. Schünemann, Andrea Darzi, Jaris Swidrovich, Rachel Couban, Kian Torabiardakani, Gordon H. Guyatt, Daniela Montalva‐Romero
article en
1 citations

Abstract

ABSTRACT Introduction Chronic pain affects 1 in 5 adults and children globally; however, management remains highly variable and low value care is common. Inconsistent recommendations among clinical practice guidelines for management of chronic pain contribute to suboptimal patient management. We will develop and disseminate a living digital chronic pain recommendation map (e‐Chronic Pain RecMap) to identify trustworthy recommendations in three high priority areas, (1) opioids, (2) cannabis for medical purposes, and (3) spine‐related interventional procedures for chronic pain. Methods The project comprises three phases. A planning phase to engage a diverse group of interest holders to co‐design a team structure with our knowledge users to ensure an efficient and effective workflow. Through a search of electronic databases and a manual search of international websites, a development phase to systematically identify relevant guidelines published in any language since 2019. In this development phase, we will update our searches every 6 months. Also, we will appraise the reporting quality of eligible guidelines using the AGREE‐II instrument, followed by appraisal of recommendation‐level quality using AGREE‐REX for guidelines meeting a defined threshold. In a next step, we will extract data from guidelines including relevant equity information using infrastructure in GRADEPro, and explore divergence and compare recommendations answering the same guideline question. Lastly, we will develop plain language summaries of trustworthy recommendations and decision aids to support patient‐physician decision making, and translate the platform to French, Spanish, and Mandarin. Finally, a mobilization phase in which, with our interest holders, we will co‐create strategies to disseminate the RecMap to relevant target users. Discussion The Chronic Pain RecMap will enhance use of trustworthy guideline recommendations by people living with chronic pain, clinicians, and decision makers. Successful uptake will optimize evidence‐based pain management.

Clinical and Public Health GuidelinesVol. 2(4)
Humanitas University (IT), University of Ottawa (CA), University of Toronto (CA), McMaster University Medical Centre (CA), Universidad de Antioquia (CO), Instituto de Cancerología Las Américas (CO), Bruyère (CA), Impact (CA), McMaster University (CA)
American University of Beirut, Lanzhou University, University of Adelaide, Beijing University of Chinese Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Canadian Institutes of Health Research
Openalex Percentile: Top 13%
Clinical practice guidelines implementation
1.88
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