Treatment

APS Guidelines Set High Standard of Excellence

The Annals of Internal Medicine¹ recently published a systematic review and appraisal of guidelines for use of opioids to treat chronic pain. The authors used the AGREE II method and the AMSTAR ratings system to evaluate 13 guidelines and the underlying systematic reviews. Of the 13 guidelines evaluated, only two received high scores on both ratings systems, one being the APS-American Academy of Pain Medicine Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain.² Reviewers noted the outstanding guidelines were developed by using comprehensive systematic reviews and rigorous methods for formulating recommendations and frequently link recommendations to evidence.

This finding is consistent with the APS commitment to produce the highest quality guidelines following the most rigorous standards and methods for guideline development.

Two new guidelines were be published in The Journal of Pain in 2014: Methadone Safety: Clinical Guidelines, the product of a collaboration with the College on Problems of Drug Dependence and the Heart Rhythm Society, and Management of Acute Post-Operative Pain, developed collaboratively with the American Society of Anesthesiology, the Department of Veterans Affairs, and the Department of Defense.

APS members consistently rate the evidence-based guidelines of our organization among the top three most valued programs of the society. While there is high value in developing guidelines for pain treatment, it is an expensive endeavor to do so. APS has recently embarked on a focused effort to secure funding to support our guideline development program. As part of this effort, methods are being implemented to obtain data regarding guideline implementation and impact on practice change. With stronger outcomes data on the impact of APS guidelines, we hope to build the case for funding the updating of existing guidelines and the development of new guidelines. The APS Clinical Practice Guidelines Committee welcomes ideas and comments about future guidelines and potential funding avenues.

1. Nuckols, T. K., Anderson, L., Popescu, I., Diamant, A. L., Doyle, B., Di Capua, P. (2014). Opioid Prescribing: A Systematic Review and Critical Appraisal of Guidelines for Chronic Pain. Ann Intern Med. 160(1):38–47. doi:10.7326/0003-4819-160-1-201401070-00732
2. Chou, R., Fanciullo, G. J., Fine, P. G., Adler, J. A., Ballantyne, J. C., Davies, P., et al. (2009). Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. J Pain. 10(2):113–130. doi: 10.1016/j.jpain.2008.10.008