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Papers of the Week

Papers: 29 May 2021 - 4 Jun 2021

Human Studies

2021 May 28


Rapid evidence and gap map of virtual care solutions across a stepped care continuum for youth with chronic pain and their families in response to the COVID-19 pandemic.


Birnie KA, Pavlova M, Neville A, Noel M, Jordan I, Jordan E, Marianayagam J, Stinson J, Lorenzetti DL, Faulkner V, Killackey T, Campbell F, Lalloo C
Pain. 2021 May 28.
PMID: 34050111.


Poor access to pediatric chronic pain care is a longstanding concern. The COVID-19 pandemic has necessitated virtual care delivery at an unprecedented pace and scale. We conducted a scoping review to create an interactive Evidence and Gap Map (EGM) of virtual care solutions across a stepped care continuum (i.e., from self-directed to specialist care) for youth with chronic pain and their families. Review methodology was co-designed with 8 youth with chronic pain and 7 parents/caregivers. Data sources included peer-reviewed scientific literature, grey literature (app stores, websites), and a call for innovations. Records were independently coded and assessed for quality. Overall, 185 records were included (105 scientific records, 56 apps, 16 websites, and 8 innovations). Most virtual care solutions were applicable across pediatric chronic pain diagnoses, with the greatest proportion at lower levels of stepped care (i.e., >100 self-guided apps and websites). Virtual delivery of psychological strategies was common. Evidence gaps were noted at higher levels of stepped care (i.e., requiring more resource and health professional involvement), integration with health records, communication with health professionals, web accessibility, and content addressing social/family support, medications, school, substance use, sleep, diet, and acute pain flares or crises. EGMs are a novel visual knowledge synthesis tool that enable rapid evidence-informed decision-making by patients and families, health professionals, and policymakers. This EGM identified high quality virtual care solutions for immediate scale and spread, and areas with no evidence in need of prioritization. Virtual care should address priorities identified by youth with chronic pain and their families.