The AHRQ Evidence-based Practice Center (EPC) Program supports healthcare quality by providing the best available evidence on medications, devices, and healthcare services to help healthcare professionals, patients, policymakers, and healthcare systems make informed and evidence-based healthcare decisions. The EPC Program supports the overall AHRQ mission of producing evidence to make healthcare safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used. The systematic synthesis of evidence reveals evidence gaps. These evidence gaps can inform future research studies, the findings from which can improve clinical practice, care delivery, and the Nation's overall health and well-being.
Pain is a significant public health challenge in the United States, affecting millions of individuals and impacting physical and mental function. To identify gaps in the evidence for treatment and management of pain, the EPC Program examined all reviews completed by an AHRQ EPC from September 2019 to September 2022, and included any review examining the treatment or management of acute and chronic pain.
The identified reviews are presented in this report in descending order by date, from newest to oldest. The purpose, key messages, and evidence gaps identified in each review are summarized. Evidence gaps are organized by population, intervention, outcomes, and study design to facilitate ease of use. Detailed descriptions of the gaps are also available in the original report as provided in hyperlinks.
A thematic analysis of evidence gaps identified across reports that addressed pain revealed the following research needs:
- Population. Improved recruitment is needed for older adults, individuals with pain-related diseases and chronic pain conditions (e.g., neuropathic pain, chronic migraine), individuals with comorbidities, individuals of diverse races and ethnicities (e.g., non-White individuals), and the medically underserved (e.g., rural populations, individuals with lower socioeconomic status).
- Interventions. Research needs to provide more details about the development and implementation of interventions (e.g., program structure, coordination, delivery, accessibility, acceptability, participant cost).
- Outcomes. More research should examine outcomes assessing quality of life, functionality, and others that are patient-centered (e.g., patient engagement).
- Study design. In general, longer followup periods, study expansion to multiple sites, and the recruitment of larger sample sizes can help address evidence gaps.
The evidence gaps identified in this report (Table 1) are provided to inform research funders, researchers, and policymakers about the types of issues that need to be addressed and the types of studies necessary to address these questions.
Carr A, Iyer S, Kato E, Niebuhr DW, Huppert J, Chang C, Umscheid CA. AHRQ EPC Program Research Gaps Summary: Pain Management. Methods Research Report. AHRQ Publication No 23-EHC006. Rockville, MD: Agency for Healthcare Research and Quality; January 2023. DOI: https://doi.org/10.23970/AHRQEPCGAPSPAINMGMT. Posted final reports are located on the Effective Health Care Program search page.