Canadian Pain Task Force Meeting: June 30, 2020

Canadian Pain Task Force Meeting: June 30, 2020, 14:00-16:00 EST

Via videoconference

Meeting Summary

Objectives

• Joint check-in with Task Force, External Advisory Panel, and Secretariat
• Meet with the leads from Hill & Knowlton to discuss online consultation analysis and planning for Phase II report as well as leads for rapid review and economic costing work
• Provide status updates on various ongoing projects and engagements

Participants

Task Force: Fiona Campbell, Maria Hudspith, Manon Choinière, Hani El-Gabalawy, Jacques Laliberté, Jaris Swidrovich, Linda Wilhelm

External Advisory Panel: Norm Buckley, Christine Chambers, Chloe Crosschild, Gilles Lavigne, Justina Marianayagam, Laura Murphy, Steven Passmore, Dean Penney, John Pereira, Patricia Poulin, Kathy Reid, Colleen Varcoe, Gerald Zamponi

Regrets: Anshu Gupta, Jennifer Harris, David Lussier

Secretariat: Dhilal Alhaboob, Baies Haqani, Pamela Rizzo, Andrew Taylor, Megan Wyszynski, Lindsey Yessick

Special Guests: Jennifer Field, Michael Sauve, and Peter Wilton (Hill and Knowlton), Brian Hutton, Danielle Rice, and Dianna Wolfe (Drug Safety and Effectiveness Network), Olga Milliken, Thy Dinh (Strategic Policy Branch, Health Canada)

Welcome

• The Secretariat welcomed everyone and provided an overview of the meeting objectives and agenda.
• No significant updates to Task Force or External Advisory Panel members' affiliations or interests.

Overview of analysis plan, preliminary themes, and potential report outlines

• Members discussed and provided direction on the analysis plan, preliminary themes, and timelines for the Phase II report.
• The leads from Hill and Knowlton provided an overview of the preliminary findings from the online consultation including demographic information and main findings by theme and question outlining elements of an improved approach to understand, prevent, and manage pain in Canada. Major themes discussed includes:
  • Gaps and barriers due to lack of access, stigma, and a lack of availability of care.
  • Potential solutions to the challenges and barriers include awareness and education to increase trust and reduce stigma, more research across disciplines and treatments.
  • Best-practices related to multi-modal treatment plans and the critical role of allied health professionals were highlighted, as well as the increased willingness of medical professionals to better understand chronic pain.
  • Priorities in research including psychological, physical, and self-management interventions, patient engagement in research, and peer support were emphasized.
  • Collaborative research, public awareness, education, and a focus on prevention were discussed as important strategies for understanding, preventing, and managing pain in Canada.
• Members highlighted their interest in emphasizing prevention of chronic pain and reducing the transition of acute to chronic pain throughout the analysis as well as distinguishing findings based on different demographic and population groups.
• An outline of the next steps was discussed including the completion of primary data analysis, cross tabulation and SGBA+ analysis, and development of the draft report in early August.

Drug Safety and Effectiveness Network rapid evidence reviews

• Members from the Drug Safety and Effectiveness Network (DSEN) provided the results of the two updated reviews. These reviews were conducted to expand the findings of two previous reviews presented in April 2020. Findings are presented as cumulative evidence of both reviews.
• Rapid Review #1: preventing transition from acute to chronic
  • Leads discussed the additional study criteria included to expand the evidence base presented in the April review.
  • A majority of guidelines were not generalizable and are specific to certain surgical treatments. However, the DSEN review provided a list of possible generalizable treatments to reduce risk of transition from acute to chronic pain.
  • Members discussed the importance of exploring risk factors for transition from acute to chronic pain, based on a targeted review and key papers submitted by members. They also noted how the lack of generalizable findings is indicative of the need for tailored treatment based on individual needs.
• Rapid Review #2: managing pain, mental illness and problematic substance use
  • Leads discussed the additional study criteria included to expand the evidence base presented in the April review.
  • Relative to mental health conditions, there were very few clinical practice guidelines for substance use disorders. Clinical practice guidelines for mental health conditions rarely include recommendations for managing chronic pain.
  • DSEN found a lack of reviews that consider populations with multiple conditions.
• A final technical report building from the previous version submitted in April 2020 will be provided on July 17th. DSEN will also be exploring two articles for publication.

Preliminary findings from the Cost of Chronic Pain in Canada project:

• The Policy, Research, Economics, and Analytics unit (PREA) at Health Canada prepared a status update and next steps presentation on the ongoing cost estimate of the economic burden of chronic pain in Canada.
• The objectives of the project are:
  • To estimate the annual and projected cost of chronic pain in Canada.
  • To estimate the economic impact of improving access to appropriate treatments/interventions and, if/where possible, estimate the return-on-investment.
• PREA presented the preliminary findings, including direct costs (health care). Members then had an opportunity to provide feedback and comments to the presentation provided by PREA. Limitations with the current approach were highlighted and discussed with the TF and EAP.
• Next steps include the estimation of indirect costs, conducting sensitivity analysis, and reporting their findings in the Phase II report.

Next steps and follow-up items

• The Task Force will meet on July 23 for an update on Phase II inputs.
• The Task Force and External Advisory Panel will reconvene in September to review the final draft Phase II report.