Research priorities for pediatric pain management in emergency medicine.

BACKGROUND

There is a high prevalence of acute pain in children cared for in the emergency care setting. However, there are still significant gaps in knowledge regarding optimal pain management. We aimed to develop a prioritized research agenda that identifies key questions for pediatric pain management in the emergency care setting that will guide future research and optimize care for children.

METHODS

We used a modified Delphi approach to achieve consensus among a multidisciplinary and geographically diverse expert advisory group. An initial list of 108 research questions was identified, with successive rounds of questionnaires conducted until there was a convergence of opinion or a point of diminishing returns was reached. The list was iteratively refined each round by advisory group members who ranked research questions and provided suggestions for potential additional questions and feedback regarding questions considered.

RESULTS

Twenty-nine advisory group members participated in the modified Delphi approach. Over the course of two rounds, we identified 10 research questions as the highest priority for future investigation. These questions included topics addressing short- and long-term outcomes related to inadequately assessed and treated pain, patient- and family-centered outcomes, optimizing analgesia in the emergency department (ED) and at home after discharge from the ED, nonpharmacologic/integrative treatments, novel analgesic treatments and strategies, children with difficult-to-treat pain, prehospital pain management, eliminating health disparities, opioid misuse/abuse, and dissemination and implementation.

CONCLUSIONS

The 10 research questions identified as highest priority can inform future work by researchers, funders, policy makers, and other key decision makers who aim to meaningfully advance the management of pain in children cared for in the emergency care setting.