Summary This guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years. It updates the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 (MMWR Recomm Rep 2016;65[No. RR-1]:1–49) and includes recommendations for managing acute (duration of <1 month), subacute (duration of 1–3 months), and chronic (duration of >3 months) pain. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care. The guideline addresses the following four areas: 1) determining whether or not to initiate opioids for pain, 2) selecting opioids and determining opioid dosages, 3) deciding duration of initial opioid prescription and conducting follow-up, and 4) assessing risk and addressing potential harms of opioid use. CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Recommendations are based on systematic reviews of the scientific evidence and reflect considerations of benefits and harms, patient and clinician values and preferences, and resource allocation. CDC obtained input from the Board of Scientific Counselors of the National Center for Injury Prevention and Control (a federally chartered advisory committee), the public, and peer reviewers. CDC recommends that persons with pain receive appropriate pain treatment, with careful consideration of the benefits and risks of all treatment options in the context of the patient’s circumstances. Recommendations should not be applied as inflexible standards of care across patient populations. This clinical practice guideline is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death.

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CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022

Background:For patients with chronic, non-cancer pain, traditional pain-relieving medications include opioids, which have shown benefits but are associated with increased risks of addiction and adv...

https://journals.sagepub.com/doi/pdf/10.1177/1179544120906461

Cannabinoids in Chronic Non-Cancer Pain: A Systematic Review and Meta-Analysis:

Implementation research is increasingly used to identify common implementation problems and key barriers and facilitators influencing efficient access to health interventions. To develop and propose an equity-based framework for Implementation Research (EquIR) of health programs, policies and systems. A systematic search of models and conceptual frameworks involving equity in the implementation of health programs, policies and systems was conducted in Medline (PubMed), Embase, LILACS, Scopus and grey literature. Key characteristics of models and conceptual frameworks were summarized. We identified key aspects of equity in the context of seven Latin American countries-focused health programs We gathered information related to the awareness of inequalities in health policy, systems and programs, the potential negative impact of increasing inequalities in disadvantaged populations, and the strategies used to reduce them. A conceptual framework of EquIR was developed. It includes elements of equity-focused implementation research, but it also links the population health status before and after the implementation, including relevant aspects of health equity before, during and after the implementation. Additionally, health sectors were included, linked with social determinants of health through the “health in all policies” proposal affecting universal health and the potential impact of the public health and public policies. EquIR is a conceptual framework that is proposed for use by decision makers and researchers during the implementation of programs, policies or health interventions, with a focus on equity, which aims to reduce or prevent the increase of existing inequalities during implementation.

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Conceptual framework of equity-focused implementation research for health programs (EquIR)

GRADE equity guidelines 4: considering health equity in GRADE guideline development: evidence to decision process.

This document summarizes principles and methodology to guide the creation of Clinical Practice Guidelines, Position Statements und Technological Reviews of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). The purpose of EFSUMB Clinical Practice Guidelines is to provide physicians and sonographers performing or requesting diagnostic and interventional ultrasound examinations with evidence-based recommendations. Position Statements summarize EFSUMB opinions on important current issues in clinical applications, education and training of ultrasound techniques or health care policy related to ultrasound-based imaging and ultrasound-guided interventions. The third type of EFSUMB policy document is the Technological Review, which describes ultrasound techniques and technologies for physicians, medical technicians, engineers and physicists developing ultrasound technology. The whole process of development of EFSUMB policy documents is explained beginning with the decision regarding topics, selection of authors, funding, and planning of the developmental process. Further steps described in this document are the review of the evidence, creation of recommendations, statements and comments, grading of level of evidence and strength of recommendations, and consensus process. Finally, rules for the creation, review, approval, publication and update of EFSUMB policy documents are described.

/pdf/european-federation-of-societies-for-ultrasound-in-medicine-5ajaf1ieke.pdf

European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Policy Document Development Strategy – Clinical Practice Guidelines, Position Statements and Technological Reviews

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GRADE equity guidelines 1: considering health equity in GRADE guideline development: introduction and rationale.