Experiences, perceptions and attitudes of health and social care professionals to management of children’s chronic non-cancer pain – a qualitative evidence synthesis

Background & Rationale Chronic non-cancer pain in childhood is widespread, affecting around 20% to 35% of children and young people globally. Chronic pain adversely affects children’s lives and quality of life and is associated with higher use of health services and medication. The NHS spends around four billion pounds a year treating just adolescent pain. In the UK, there are few specialised chronic non-cancer pain services for children, large gaps in knowledge about the best treatments, and insufficient training of UK-based healthcare professionals in children’s chronic pain management. Nevertheless, health and social care professionals must still assess children with chronic pain and consider which treatments to offer. To improve services and treatments, and hence outcomes for children and their families, there is an urgent need for research to enhance our understanding of how health and social care professionals assess and treat children with chronic pain. Review question What are the experiences, perceptions and attitudes of health and social care professionals in the United Kingdom and other high-income countries regarding the assessment and management of chronic non-cancer pain in children? Design & Methods We will conduct a qualitative evidence synthesis using thematic synthesis methodology. We will search six bibliographic databases and conduct supplementary searches to identify published and unpublished empirical qualitative and mixed-methods studies reporting the perceptions, experiences and attitudes of health and social care professionals who manage chronic non-cancer pain in children aged 3 months to 18 years. Two reviewers will independently screen titles, abstracts and full texts of retrieved references against eligibility criteria using Covidence systematic review management software. One reviewer will extract data on study and participant characteristics (e.g., study design and aim, setting, professional role and grade, patient group), which a second reviewer will check. Two reviewers will code and analyse study findings using QSR NVivo software, appraise methodological limitations using CAMELOT (CochrAne qualitative Methodological LimitatiOns Tool), and assess confidence in review findings using GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research). Patient and Public Involvement (PPI) A project PPI group of young people with chronic pain and parents will be recruited. They will collaborate on study selection, interpreting findings, and dissemination. We will also involve a stakeholder group of health and social care professionals with expertise in children’s chronic pain. Dissemination, outputs & anticipated impact We will disseminate widely to academic, lay, clinical and policy audiences. Outputs will include a journal article, conference presentations, blog posts, and social media posts. Ultimately, this review will inform and could improve the care provided, and thus the health and quality of life of children with chronic pain and their families, and reduce burden on the NHS.