Poulin Patricia, Shergill Yaadwinder, Romanow Heather, Busse Jason W, Chambers Christine T, Cooper Lynn, Forgeron Paula A, Olsen Harper Anita, Hudspith Maria, Iorio Alfonso, Lalloo Chitra, Ouellette Carley, Robertson Rosalind, Smeenk Sandy, Stevens Bonnie, Stinson Jennifer
The Ottawa Hospital Research Institute, The Ottawa Hospital Pain Clinic, Ottawa, ON, Canada.
School of Psychology, Faculty of Social Sciences, Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Can J Pain. 2018 Jul 19;2(1):191-204. doi: 10.1080/24740527.2018.1433959. eCollection 2018.
Chronic pain affects more than 6 million Canadians. Patients need to be involved in setting research priorities to ensure a focus on areas important to those who will be most impacted by the results.
The aim of this study was to leverage patient experiences to identify chronic pain research priorities in Canada.
The process was informed by the James Lind Alliance. After gathering an exhaustive list of questions using surveys, town hall meetings, interviews, and social media consultations, we used a computerized Delphi with four successive iterations to select the final list of research priorities. The final Delphi round was conducted by a panel of ten patients living with chronic pain and ten clinicians from different disciplines.
We received more than 5000 suggestions from 1500 people. The Delphi process led to the identification of 14 questions fitting under the following 4 themes: (1) improving knowledge and competencies in chronic pain; (2) improving patient-centered chronic pain care; (3) preventing chronic pain and reducing associated symptoms; and (4) improving access to and coordination of patient-centered chronic pain care. Challenges included the issue of chronic pain being ubiquitous to many diseases, leading to many initial suggestions focusing on these diseases. We also identified the need for further engagement efforts with marginalized groups in order to validate the priorities identified or identify different sets of priorities specific to these groups.
The priorities identified can guide patient-oriented chronic pain research to ultimately improve the care offered to people living with chronic pain.
慢性疼痛影响着超过600万加拿大人。患者需要参与确定研究重点,以确保关注对那些将受研究结果影响最大的人群至关重要的领域。
本研究的目的是利用患者的经验来确定加拿大慢性疼痛研究的重点。
该过程参考了詹姆斯·林德联盟的做法。通过调查、市政厅会议、访谈和社交媒体咨询收集了详尽的问题清单后,我们采用计算机化德尔菲法进行了连续四轮迭代,以选出最终的研究重点清单。最后一轮德尔菲调查由10名慢性疼痛患者和10名来自不同学科的临床医生组成的小组进行。
我们收到了来自1500人的5000多条建议。德尔菲法确定了14个问题,分属以下4个主题:(1)提高慢性疼痛方面的知识和能力;(2)改善以患者为中心的慢性疼痛护理;(3)预防慢性疼痛并减轻相关症状;(4)改善以患者为中心的慢性疼痛护理的可及性和协调性。挑战包括慢性疼痛在许多疾病中普遍存在这一问题,导致许多最初的建议都集中在这些疾病上。我们还确定需要进一步与边缘化群体进行接触,以验证所确定的重点或确定这些群体特有的不同重点。
确定的重点可为以患者为导向的慢性疼痛研究提供指导,最终改善为慢性疼痛患者提供的护理。