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Review
. 2021 Nov 1;162(11):2658-2668.
doi: 10.1097/j.pain.0000000000002339.

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

Kathryn A Birnie  1   2   3   4 , Maria Pavlova  5 , Alexandra Neville  5 , Melanie Noel  3   5 , Isabel Jordan  4 , Evie Jordan  1   2   3   4   5   6   7   8   9   10   11 , Justina Marianayagam  4   6 , Jennifer Stinson  4   7   8 , Diane L Lorenzetti  9 , Violeta Faulkner  1 , Tieghan Killackey  7 , Fiona Campbell  4   10 , Chitra Lalloo  7   11
Affiliations
Review

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

Kathryn A Birnie et al. Pain. .

Abstract

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 of virtual care solutions across a stepped care continuum (ie, from self-directed to specialist care) for youth with chronic pain and their families. Review methodology was codesigned with 8 youth with chronic pain and 7 parents/caregivers. Data sources included peer-reviewed scientific literature, gray literature (app stores and web sites), and a call for innovations. Records were independently coded and assessed for quality. Overall, 185 records were included (105 scientific records, 56 apps, 16 web sites, and 8 innovations). Most virtual care solutions were applicable across pediatric chronic pain diagnoses, with the greatest proportion at lower levels of stepped care (ie, >100 self-guided apps and web sites). Virtual delivery of psychological strategies was common. Evidence gaps were noted at higher levels of stepped care (ie, 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. Evidence and Gap Maps are a novel visual knowledge synthesis tool, which enable rapid evidence-informed decision-making by patients and families, health professionals, and policymakers. This evidence and gap map 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.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1.
Figure 1.
Levels of stepped care.
Figure 2.
Figure 2.
PRISMA flow diagram.
Figure 3.
Figure 3.
Static version of the evidence and gap map with higher order components of virtual care. Interactive Evidence and Gap Map online at www.partneringforpain.com/portfolio/virtual-care.
See this image and copyright information in PMC

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