Objective To develop a clinical practice guideline to support the management of chronic pain, including low back, osteoarthritic, and neuropathic pain in primary care.
MethodsThe guideline was developed with an emphasis on best available evidence and shared decision-making principles. Ten health professionals (4 generalist family physicians, 1 pain management-focused family physician, 1 anesthesiologist, 1 physical therapist, 1 pharmacist, 1 nurse practitioner, and 1 psychologist), a patient representative, and a nonvoting pharmacist and guideline methodologist comprised the Guideline Committee. Member selection was based on profession, practice setting, and lack of financial conflicts of interest. The guideline process was iterative in identification of key questions, evidence review, and development of guideline recommendations. Three systematic reviews, including a total of 285 randomized controlled trials, were completed. Randomized controlled trials were included only if they reported a responder analysis (eg, how many patients achieved a 30% or greater reduction in pain). The committee directed an Evidence Team (composed of evidence experts) to address an additional 11 complementary questions. Key recommendations were derived through committee consensus. The guideline and shared decision-making tools underwent extensive review by clinicians and patients before publication.This article is eligible for Mainpro+ certified Self-Learning credits. To earn credits, go to https://www.cfp.ca and click on the Mainpro+ link. This article has been peer reviewed.
Cet article donne droit à des crédits d'autoapprentissage certifiés Mainpro+. Pour obtenir des crédits, allez à https://www.cfp.ca et cliquez sur le lien vers Mainpro+. Cet article a fait l'objet d'une revision par des pairs.
subscales mean changes were 11.54, 11.67 and 14.67 (P<0.05) respectively. Average change in Arthritis Self-Efficacy Score (ASES) pain subscale was 2.18 (P>0.05). The percentage change in quadriceps and hip abduction strength was 28% and 42% respectively (p<0.05). Category 3 wait-times for people with KOA reduced from 4 months to 2 weeks (p<0.05). Average number of supervised occasions of service for people with KOA increased from 4.
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