How can you effectively use evidence-based guidelines for chronic pain management?
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Chronic pain is a complex and challenging condition that affects millions of people worldwide. It can have a negative impact on your physical, emotional, and social well-being, as well as your ability to work, enjoy hobbies, and maintain relationships. As a patient advocate, you have a vital role in helping your clients or loved ones manage their chronic pain effectively and improve their quality of life. One of the ways you can do this is by using evidence-based guidelines for chronic pain management. These are recommendations based on the best available scientific research and clinical expertise that aim to provide safe, effective, and consistent care for people with chronic pain. In this article, we will explore how you can use evidence-based guidelines for chronic pain management in your patient advocacy practice.
Evidence-based guidelines are documents that summarize the current evidence on a specific health topic and provide recommendations for practice. They are developed by experts who review and evaluate the quality and relevance of the research, and consider the benefits, harms, costs, and preferences of different options. Evidence-based guidelines are not rigid rules, but rather tools to help you and your clients or loved ones make informed decisions about their health care. They can also help you communicate with health care providers, ask relevant questions, and advocate for your clients' or loved ones' needs and preferences.
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Eziah Zaidi-Syed
Co-Founder & CEO at Mend
In his book Outlive, Dr. Peter Attia differentiates between evidence based versus evidence informed. The former being the gospel of western medicine where we seek evidence for the impact of an intervention throughly blinded placebo controlled randomized trials. The latter allowing us to widen the aperture and consider a larger body of evidence for information on a more holistic calculus on benefits versus risk. There's a role for both in modern medicine and a comprehensive approach lies at the intersection of the two.
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Keiron Audain PhD
Food Security | Public Health | Nutrition Psychiatry
In my experience as a nutrition researcher, evidence-based clinical practice guidelines are invaluable for guiding nutrition interventions and promoting optimal health outcomes for those living with chronic pain. I advocate for increased nutrition training for chronic pain providers based on evidence showing how diets high in processed foods and sugary beverages can worsen inflammation and pain. Guidelines help provide the impetus for policy changes by demonstrating the research consensus for anti-inflammatory nutrition as a first-line therapy alongside medications and physical therapy.
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When searching for and using evidence-based guidelines for chronic pain management, it is essential to be careful and critical. You should consider the credibility and reputation of the organization or group that developed the guidelines, as well as the currency and relevance of the guidelines. Additionally, you need to assess the quality and strength of the evidence and recommendations. Be aware of any potential conflicts of interest, biases, or limitations of the guidelines. Examples of credible and current sources of evidence-based guidelines include the American Pain Society (APS), National Institute for Health and Care Excellence (NICE), and Canadian Pain Society (CPS). Each of these organizations publishes clinical practice guidelines on various aspects of chronic pain management.
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Eziah Zaidi-Syed
Co-Founder & CEO at Mend
There are also highly credible experts that have published extensively in their blogs, on LinkedIn and YouTube. The internet allows us to find valuable resources if we are just willing to dig.
Using evidence-based guidelines for chronic pain management does not mean following them rigidly or applying them uniformly to every client or loved one. Rather, it means utilizing them as a guide and resource to inform and support your patient advocacy practice. Evidence-based guidelines can be used to educate yourself and your clients or loved ones about chronic pain and its management - from the causes, mechanisms, types, and effects of chronic pain, to the available treatments, their benefits, risks, and alternatives. It can also facilitate shared decision making and informed consent by helping clients or loved ones weigh the pros and cons of different treatments, express their values, preferences, and goals, communicate with health care providers, ask relevant questions, request information and explanations, give informed consent or decline a treatment if desired. Additionally, evidence-based guidelines can be used to monitor and evaluate the outcomes and quality of care - such as tracking effectiveness, safety, satisfaction of treatments; identifying and reporting any problems; side effects; or complications; comparing and assessing the quality of care received; as well as advocating for changes or improvements if necessary.
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Eziah Zaidi-Syed
Co-Founder & CEO at Mend
Pain can be an incredibly complex interplay of biopsychosocial variables. My brother, a PT, has educated me in understanding that pain localized in one area (e.g. knee) can be originating from a source in another area (neck). Stress and cortisol can play a role. Nutritional status can play a role. Muscle weakness can play a role. Systemic inflammation in the body can play a role. I believe it's incredibly important to find the right expert who utilizes an evidence-informed holistic approach. The appropriate comprehensive approach and model can be profound in alleviating or even eliminating chronic pain.
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Ani Rostomyan, PharmD, BCPS, APh
CEO @ SheAni Wellness™ | Executive Coach| Positive Psychology | Burnout Coach| Hypnobreathwork instructor
What I can add is what we use in clinical practice a personalized and comprehensive approach to the management of persistent pain known as the Five A's of Pain Management: analgesia, activities of daily living, adverse effects, affect, and aberrant drug-related behaviors.
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Using evidence-based guidelines for chronic pain management can provide numerous advantages for you and your clients or loved ones. These guidelines can improve the quality and consistency of care, enhancing patient-centeredness and empowerment. Additionally, they can reduce the uncertainty and variability of care, ensuring that your clients or loved ones have a clear understanding of their treatments and what to do if they have questions or concerns. Evidence-based guidelines can also help ensure that your clients or loved ones receive the best possible care based on current scientific knowledge and clinical expertise, while also involving them in their care decisions and tailoring care to their individual needs, preferences, and goals.
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Ani Rostomyan, PharmD, BCPS, APh
CEO @ SheAni Wellness™ | Executive Coach| Positive Psychology | Burnout Coach| Hypnobreathwork instructor
Agreed it’s imperative to follow the best available evidence in managing chronic pain. We need to emphasize that evidence based practice is essential not only for clinical practice, but also, is an integral component of patient's autonomy and prevents against any medico-legal suit. So, evidence based pain practice provides authentic, trustworthy, tested with robust clinical trials and their systematic analysis for transferring acquired knowledge into clinical practice
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Keiron Audain PhD
Food Security | Public Health | Nutrition Psychiatry
In my view, a key benefit of evidence-based guidelines for chronic pain is empowering patients to collaborate in their care. When people understand the recommendations grounded in rigorous research, they can better advocate for appropriate, personalized treatment. Guidelines promote quality care by reducing unwarranted variations in pain management approaches. They provide a roadmap for delivering optimal interventions tailored to each patient's needs and goals. Evidence-based guidelines are invaluable for translating complex research into practical strategies that improve quality of life. They maximize the impact of science and help build healthier communities.
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Using evidence-based guidelines for chronic pain management is not without challenges. Finding and accessing reliable and relevant evidence-based guidelines can be time consuming and difficult. Furthermore, applying and adapting evidence-based guidelines to individual cases and contexts can be tricky, as the guidelines are based on average outcomes of a large group of people. Additionally, there may be gaps, uncertainties, or controversies in the evidence or recommendations which need to be acknowledged. As such, one needs to use their judgment and experience, consult with clients or loved ones, balance the evidence-based guidelines with other sources of information, and be prepared to update or revise their use of evidence-based guidelines as new evidence or guidelines emerge.
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Keiron Audain PhD
Food Security | Public Health | Nutrition Psychiatry
In my view, a key challenge with evidence-based chronic pain guidelines is balancing group evidence with individual variability. Guidelines summarize average research outcomes and may not account for each patient's unique needs. Applying them requires judgment to adapt recommendations. For example, guidelines may prescribe exercise for chronic lower back pain, but some patients have physical limitations requiring creative adaptations. Guidelines also lag behind new evidence, so staying current is difficult. Still, used discerningly, guidelines provide a helpful starting point for empowering patients through information. The key is maintaining realistic expectations and utilizing guidelines as one component of shared decision-making.
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