Consolidation, Systematic Appraisal and Comparison of Guideline Recommendations Regarding Management of Chronic Pain:...

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.

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.

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.