Kathryn A Birnie1, Carley Ouellette2, Tamara Do Amaral3, Jennifer N Stinson3,4. 1. Department of Anesthesiology, Perioperative and Pain Medicine, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada. 2. Faculty of Nursing, McMaster University, Hamilton, Ontario, Canada. 3. Child Health Evaluative Sciences, The Hospital for Sick Children Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada. 4. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Abstract
Background: Reviews in pediatric chronic pain often focus on only one intervention or population, making it difficult for policymakers and decision makers to quickly synthesize knowledge to inform larger-scale policy and funding priorities. Aims: The aims of this study were to (1) create an evidence and gap map of interventions for pediatric chronic pain and (2) identify gaps between existing evidence and recently identified patient-oriented research priorities. Methods: We performed a systematic review of English-language peer-reviewed systematic reviews or clinical practice guidelines of pediatric chronic pain intervention published in the past 20 years. Database searches of Medline, Embase, PsycINFO, Web of Science, CINAHL, and SCOPUS were conducted inclusive to June 3, 2019. Review quality was assessed using the AMSTAR-2. Results: Of 4168 unique abstracts, 50 systematic reviews (including 2 clinical practice guidelines) crossing diverse pediatric chronic pain populations and intervention settings were included. One third were rated high quality, with half rated low to critically low quality. The largest proportion of reviews addressed psychological and pharmacological interventions, followed by interdisciplinary, other (e.g., dietary), and physical interventions. Most common outcomes included pain, physical, emotional, and role functioning and quality of life. Treatment satisfaction and adverse events were less common, with minimal report of sleep or economic factors. Most patient-oriented research priorities had not been investigated. Conclusions: Sufficient quality evidence is available to guide evidence-informed policies in pediatric chronic pain, most notably regarding psychological and pharmacological interventions. Numerous evidence gaps in patient-oriented research priorities and treatment outcomes should guide prioritization of research funds, as well as study aims and design.
Background: Reviews in pediatric chronic pain often focus on only one intervention or population, making it difficult for policymakers and decision makers to quickly synthesize knowledge to inform larger-scale policy and funding priorities. Aims: The aims of this study were to (1) create an evidence and gap map of interventions for pediatric chronic pain and (2) identify gaps between existing evidence and recently identified patient-oriented research priorities. Methods: We performed a systematic review of English-language peer-reviewed systematic reviews or clinical practice guidelines of pediatric chronic pain intervention published in the past 20 years. Database searches of Medline, Embase, PsycINFO, Web of Science, CINAHL, and SCOPUS were conducted inclusive to June 3, 2019. Review quality was assessed using the AMSTAR-2. Results: Of 4168 unique abstracts, 50 systematic reviews (including 2 clinical practice guidelines) crossing diverse pediatric chronic pain populations and intervention settings were included. One third were rated high quality, with half rated low to critically low quality. The largest proportion of reviews addressed psychological and pharmacological interventions, followed by interdisciplinary, other (e.g., dietary), and physical interventions. Most common outcomes included pain, physical, emotional, and role functioning and quality of life. Treatment satisfaction and adverse events were less common, with minimal report of sleep or economic factors. Most patient-oriented research priorities had not been investigated. Conclusions: Sufficient quality evidence is available to guide evidence-informed policies in pediatric chronic pain, most notably regarding psychological and pharmacological interventions. Numerous evidence gaps in patient-oriented research priorities and treatment outcomes should guide prioritization of research funds, as well as study aims and design.
Authors: Sara King; Christine T Chambers; Anna Huguet; Rebecca C MacNevin; Patrick J McGrath; Louise Parker; Amanda J MacDonald Journal: Pain Date: 2011-12 Impact factor: 6.961
Authors: Patrick J McGrath; Gary A Walco; Dennis C Turk; Robert H Dworkin; Mark T Brown; Karina Davidson; Christopher Eccleston; G Allen Finley; Kenneth Goldschneider; Lynne Haverkos; Sharon H Hertz; Gustaf Ljungman; Tonya Palermo; Bob A Rappaport; Thomas Rhodes; Neil Schechter; Jane Scott; Navil Sethna; Ola K Svensson; Jennifer Stinson; Carl L von Baeyer; Lynn Walker; Steven Weisman; Richard E White; Anne Zajicek; Lonnie Zeltzer Journal: J Pain Date: 2008-06-17 Impact factor: 5.820
Authors: R Boulkedid; A Y Abdou; E Desselas; M Monégat; T G de Leeuw; J Avez-Couturier; S Dugue; C Mareau; B Charron; C Alberti; F Kaguelidou Journal: Eur J Pain Date: 2017-11-05 Impact factor: 3.931
Authors: Beverley J Shea; Barnaby C Reeves; George Wells; Micere Thuku; Candyce Hamel; Julian Moran; David Moher; Peter Tugwell; Vivian Welch; Elizabeth Kristjansson; David A Henry Journal: BMJ Date: 2017-09-21
Authors: Linde N Nijhof; Merel M Nap-van der Vlist; Elise M van de Putte; Annet van Royen-Kerkhof; Sanne L Nijhof Journal: Rheumatol Int Date: 2018-08-23 Impact factor: 2.631
Authors: M C Scheper; R H H Engelbert; E A A Rameckers; J Verbunt; L Remvig; B Juul-Kristensen Journal: Biomed Res Int Date: 2013-07-22 Impact factor: 3.411
Authors: Lindsay T Ives; Kate Stein; Alannah M Rivera-Cancel; Julia K Nicholas; Kristen Caldwell; Nandini Datta; Christian Mauro; Helen Egger; Eve Puffer; Nancy L Zucker Journal: Children (Basel) Date: 2021-05-27
Authors: Tonya M Palermo; Gary A Walco; Unmesha Roy Paladhi; Kathryn A Birnie; Geert Crombez; Rocio de la Vega; Christopher Eccleston; Susmita Kashikar-Zuck; Amanda L Stone Journal: Pain Date: 2021-10-01 Impact factor: 6.961