Management of chronic pain in children and young people: summary

A summary of the available evidence, combined with a consensus group agreement on key recommendations and suggested patient pathways.


Appendix 2: Key questions

1. In patients with chronic non-malignant pain being managed is there any evidence that timing of referral or treatment impacts on outcomes?

2. In patients with chronic non-malignant pain is there any evidence that the nature of interaction with healthcare professionals, education system and parents affects patient outcomes?

3. In patients with chronic non-malignant pain are opioids effective compared with placebo or other interventions in pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events/drug reactions, dependency (physiological or psychological).

4. In patients with chronic non-malignant pain what are the most effective simple analgesics compared with placebo or other interventions on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events/drug reactions, dependency (physiological or psychological).

5. In patients with chronic non-malignant pain what is the effectiveness of anticonvulsants compared with placebo or other interventions on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse drug reactions, dependency (physiological or psychological).

6. In patients with chronic non-malignant pain what is the effectiveness of topical analgesics compared with placebo or other interventions on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events/drug reactions, dependency (physiological or psychological)?

7. In patients with chronic non-malignant pain what is the effectiveness of antidepressants compared with placebo or other interventions on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events/drug reactions, dependency (physiological or psychological).

8. In patients with chronic non-malignant pain what is the effectiveness of non-standard analgesics compared with placebo or other interventions on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events/drug reactions, dependency (physiological or psychological).

9. In patients with chronic non-malignant pain what is the effectiveness of physical therapies compared with no physical therapy or other interventions on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events.

10. In patients with chronic non-malignant pain what is the effectiveness of complementary and alternative therapies compared with no treatment or other interventions on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events.

11. In patients with chronic non-malignant pain what is the effectiveness of expert/clinician guided self-help management advice/ programmes/psychological treatments compared with no treatment or other interventions on pain scores, functional ability, mood, QoL and adverse events.

12. In patients with chronic non-malignant pain is there any evidence for the effectiveness of dietary interventions compared with usual care on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events.

13. In patients with chronic non-malignant pain what is the effectiveness of surgery, nerve blocks compared with no intervention on pain scores (30% reduction and 50% reduction), functional ability, quality of life, adverse events.

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