On the 20th June 2019, Cochrane members published an overview review in the PAIN Journal on the efficacy of pharmacological interventions for children with chronic pain and cancer-related pain (https://bit.ly/2MMm5UH). The overview summarises the evidence from 23 systematic reviews, including several Cochrane Library reviews from our NIHR Programme Grant (https://papas.cochrane.org/nihr-programme-grant-2014-17). This work also builds on a policy workshop we held in 2018 focussing on this topic (https://bit.ly/2RGOGcK).

 

The overview highlights the lack of available evidence across all drugs aimed at relieving pain in children (just 6 trials of 393 participants). Therefore, we have launched a large dissemination plan to share these findings. We are publishing articles, blogs, newsletters, videos, and co-ordinating a social media campaign to help us start a conversation about the importance of evidence production in children’s pain.

 

We thank everyone who has contributed to this important piece of work. Please do feel free to use these links and distribute them widely to help us improve the science, policy and practice of paediatric pain management.

 

 

Resources

 

• Open access overview in PAIN: https://bit.ly/2MMm5UH and commentary via Ovid

 

• Cochrane Special Collection: https://bit.ly/2IM11ta

 

• Cochrane editorial: https://bit.ly/2YgN5N0

 

• Blogs on this evidence base (or its absence)
  • Pharmacotherapy for treating chronic pain in children: A need for pragmatic idealism; Thomas 2020: https://doi.org/10.1111/pan.13781 (download pdf here)
  • Body in Mind blog https://bit.ly/2Flwtwe
  • The Conversation https://bit.ly/2YeBfmI (also shared on Yahoo News here; and IOL here; and MENAFN here)
  • Evidently Cochrane https://bit.ly/2IPzerQ
  • Press release from University of Bath https://bit.ly/2LjwLYp

 

• Supporting videos
  • Dr Emma Fisher’s summary on YouTube https://bit.ly/2RDldjA
  • University of Bath video summary https://twitter.com/UniofBath/status/1143800625764999169
  • PAIN Journal Editor’s Pick video https://bit.ly/2X7HEUh

 

• Summary of the  impact story so far (2019): https://bit.ly/2ITbzXz

 

• Key people to follow on Twitter (hashtag #timeforchange)
  • @Chris_Eccleston
  • @EmmaFisher1
  • @cochranecollab
  • @CochraneUK
  • @CochraneLibrary
  • @UniofBath

 

Other external links

• Somerset Live: Bath Hospital Trust supports study into drug treatment of chronic pain in children (here)
• Medical Xpress: Researchers reveal lack of evidence for drugs prescribed to treat chronic pain in children (here)
• News Medical (Life Sciences): Are Chronic Pain Relief Drugs for Children Effective? (here; also on Medicine News Line here; and on herenciageneticayenfermedad here); and Study reveals lack of evidence for pediatric drugs prescribed to treat chronic pain (here)
• American News Report: Lack of evidence for drugs prescribed to treat chronic pain in children (here)
• EurekAlert: Researchers reveal lack of evidence for drugs prescribed to treat chronic pain in children (here)
• 7th Space: Researchers reveal lack of evidence for drugs prescribed to treat chronic pain in children (here)
• Newswise: Researchers reveal lack of evidence for drugs prescribed to treat chronic pain in children (here)
• Physical Therapy Products: Chronic Pain in Kids Needs to Be Studied More, Researchers Urge (here)
• The Independent: Children’s pain is under-researched (here - scroll down to end of page)
• Technology.org: Researchers reveal lack of evidence for drugs prescribed to treat chronic pain in children (here)
• BBC 1 West - BBC London News (here; here; here)
• BBC Bristol (here)
• Health Canal: Researchers reveal lack of evidence for drugs prescribed to treat chronic pain in children (here)
• Europa Press: in Spanish (here and here)
• The Courier & Advertiser Fife edition: Pain relief for children called into question (here - Press Reader account required)
• Health Medicine Network: Researchers reveal lack of evidence for drugs prescribed to treat chronic pain in children (here)
• ScienMag: Researchers Reveal Lack Of Evidence For Drugs Prescribed To Treat Chronic Pain In Children (here)
• Science Codex: Researchers reveal lack of evidence for drugs prescribed to treat chronic pain in children (here)
• Bioengineer.org: Researchers Reveal Lack Of Evidence For Drugs Prescribed To Treat Chronic Pain In Children (here)

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The story continues...

In 2020, Professor Christopher Eccleston, Dr Emma Fisher, and others produced The Lancet Child and Adolescent Health Commission’s report to address paediatric pain and recommend what more can be done to help children and young people: https://www.thelancet.com/commission/paediatric-pain

More links related to the Lancet launch in October 2020:

• Versus Arthritis news
• University of Bath press announcement
• The New York Times: Respecting Children’s Pain
• Artist Shaniah Barry - You can't see my pain
• Video Abstract: Delivering transformative action in paediatric pain
• The Lancet: Paediatric pain management in low-income and middle-income countries
• Follow on Twitter @LancetChildAdol
• Dalhousie University news

 

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And continues...

In December 2020, the WHO published Guidelines on the management of chronic pain in children: access here.

Our Cochrane Reviews contributed to the guideline and Dr Emma Fisher led the review of effectiveness.

Overview (taken from the guideline)

In these guidelines, the World Health Organization (WHO) provides evidence-informed recommendations for the management of chronic pain in children. The recommendations are based on the most current, high-quality scientific evidence, and were formulated following processes and using methods that meet the highest international standards for guideline development. The recommendations in this guideline are based on systematic reviews of the evidence on benefits, harms, acceptability and feasibility, as well as on equity and resource considerations. The recommendations were formulated by the Guideline Development Group, consisting of individuals with diverse expertise and experiences and with global representation. 

The purpose of this guideline is to assist WHO Member States and their partners in developing and implementing national and local policies, regulations, pain management protocols and best practices. It will help countries balance concerns about ensuring access to appropriate therapies for pain relief with the harms arising from misuse of medications and other potential adverse effects of interventions for pain management. 

These guidelines focus on physical, psychological and pharmacological interventions for the management of primary and secondary chronic pain in children 0 to 19 years of age.