Annual Report 2022-2023

Keeping hope alive through Veteran-first chronic pain research


The Advisory Council is bursting with passion to help improve the lives of Canadian Veterans and their families experiencing chronic pain and this organization truly supports and facilitates us to do so.

- Allison Gaudet, Chair, Advisory Council for Veterans
Report from the Chair of the Advisory Council for Veterans
“The role and engagement of the ACV within the CPCoE continues to expand and evolve. The ACV helps the CPCoE understand the daily challenges that Canadian Veterans and their families face as a result of their chronic pain.”
Allison Gaudet, MScPT, CIScPT, BScKinChair, Advisory Council for Veterans

The 2022-2023 year upheld the theme of progression and development for Veteran engagement within the Chronic Pain Centre of Excellence for Canadian Veterans (CPCoE). The role and engagement of the Advisory Council for Veterans (ACV) within the CPCoE continues to expand and evolve. The ACV helps the CPCoE understand the daily challenges that Canadian Veterans and their families face as a result of their chronic pain. The council is comprised of Canadian Veterans, both commissioned and non-commission ranks, along with health care providers who practiced within the Canadian Armed Forces and who currently treat Canadian Veterans. 

In August 2022, Tom Hoppe, past chair of the ACV, led a group of Veterans living with chronic pain and members of the CPCoE leadership team in the inaugural Military Veterans Alpine Challenge (MVAC). The event brought awareness and understanding of Canadian Veterans suffering with chronic pain and focused on goal setting for the Veterans, while managing their pain and building community. A 7km hike was planned and it took place up top Whistler, British Columbia, where the team was flown via helicopter. 

In September 2022, the ACV joined the annual stakeholders conference. The conference centered around Canadian Veteran’s suffering from chronic pain and other co-morbidities, as well as the influence of sex and gender. The Advisory Councils’ integral sharing of lived experience and interactive workshop sessions brought more context and clarity to the discussions for all clinicians who are invested in this journey. These two days were rich with conversation and catalysts for new partnerships and explorations. 

In February 2023, the ACV took part in the James Lind Alliance Priority Setting Partnership process. This was a full-day meeting to determine the research priorities for the 2023-2024 year. Before the meeting, 20 uncertainties were identified for future research regarding Canadian Veterans suffering with chronic pain. The ACV was asked to partake in various exercises individually, in small groups and with the group at large. A final list of priorities was established after completion of the intensive day. The dialogue was rich and insightful from all parties involved. Recruitment for new advisory council members was initiated as the term of involvement for a few members concluded. 

The ACV is proud to be part of the CPCoE as they hold authenticity and integrity as a primary value. The CPCoE supports the ACV, and they value our experience, expertise, and knowledge. The Advisory Council is bursting with passion to help improve the lives of Canadian Veterans and their families experiencing chronic pain; this organization truly supports and facilitates us to do so. We all express a very sincere thank you on behalf of the entire council. 

Report From the CEO
“We continue to work to better understand pain in Veterans and focus our research projects on topics that will allow us to make tangible recommendations to help improve Veteran and their family well-being.”
Dr. Ramesh ZachariasPresident, CEO & Medical Director

We are thrilled to have concluded the third fiscal year of the Chronic Pain Centre of Excellence for Canadian Veterans on March 31, 2023. I would like to thank Veterans Affairs Canada who have renewed our contribution agreement for the next five years. This will enable us to continue to fund research that will help Veterans and their families as well as help implement research into practice.

This past year we recruited a new Chief Scientific Officer, Dr. Abhimanyu Sud as well as Dr. Luc J. Hébert, our new Director of Research Partnerships and Chair of the Scientific Advisory Board. They have already had a positive impact on the research priorities and expanded our strategic partners. Both have been incredible additions to our team and have elevated our research to new heights. We would also like to thank Dr. Norm Buckley and Dr. Jason Busse for their leadership during the first three years of our operations.

This past year also saw the Round Table on Knowledge Mobilization into Policy. This event was facilitated by Dr. John Lavis from the McMaster Health Forum and was co-hosted by Gen (retired) Walt Natynczyk and Assistant Deputy Minister Pierre Tessier from Veterans Affairs Canada. The event was attended by representatives from the Department of National Defense, Veterans Affairs Canada, international representatives, and partners in research from CIMVHR and the Atlas Institute. The work done at this roundtable has now evolved into an Evidence Support System Working Group to assist DND and VAC in pursuing evidence when making any decisions around health care for their members.

Towards the end of the year, we were proud to host The Honourable Lawrence MacAulay, Minister of Veterans Affairs and Associate Minister of National Defence, at our Hamilton office. The Minister met with CPCoE staff as well as with Ryan and Rebekah Mitchell, a Veteran and Veteran family member. The conversation focused on the importance of interdisciplinary pain programs, our current research, and what we can do to help Veterans and their families suffering from chronic pain. 

I would like to express my gratitude to Tom Hoppe, who founded the ACV in the spring of 2020, for his leadership as Chair. Tom’s professionalism and experience shaped the group, and immensely contributed to ensuring our organization focused on topics that mattered most to Veterans. Tom has stepped down from his leadership position but will continue to remain a member of the ACV. This February meeting commenced with the appointment of a new Chair, Allison Gaudet, and new Vice-Chair, Hélène Le Scelleur, to provide leadership to the group.

Looking ahead, we continue to work to better understand pain in Veterans and focus our research projects on topics that will allow us to make tangible recommendations to help improve Veteran and their family well-being.

Impact of the CPCoE – By the Numbers

Number of Newly Initiated Research Projects
Number of Research Projects Active
Number of Research Projects to Date
Number of New Institutions
Number of Institutions
Number of New Researchers Funded
Number of Researchers Funded to Date
Amount of Money Spent of Research
Amount of Money Spent on Research to Date
Amount of Funding for Students Given
Amount of Funding for Students Given to Date
New International Project Funded
Number of Provinces Funded to Date
Number of New Cities Funded
Number of Cities Funded to Date
Number of New CBIs Funded
Number of CBIs Funded to Date
Number of presentations on CPCoE-funded research projects at academic conferences
Impact of the CPCoE – By a Research Project

Intergenerational Transmission of Chronic Pain in Canadian Veterans and their Children
Principal Investigator: Dr. Melanie Noel, Associate Professor of Clinical Psychology Department of Psychology, University of Calgary
Institution: University of Calgary

Report from the
Chief Scientific Officer
“Through a challenging but rewarding process, the ACV identified the top research priorities for the CPCoE that will help set the scientific direction for us over the next several years.”
Dr. Abhimanyu Sud, MD CCFPChief Scientific Officer

Since joining the CPCoE as Chief Scientific Officer in May 2022, I have been continually astonished by the breadth and depth of activities of this “small but mighty” organization. Whether it is in weekly internal meetings, during coordination meetings with collaborators, or at national and international conferences, the CPCoE is continuously championing the interests of Canadian Veterans living with pain.

I am extremely proud that, building on the groundwork set by my predecessor Dr. Norm Buckley, we have been able to advance the transparency and rigour with which we determine the scientific priorities of the CPCoE. As with all our work at the CPCoE, this began with extensive engagement with our Veteran advisors on the Advisory Council for Veterans (ACV) and beyond. Aligning with the James Lind Alliance Priority Setting Partnership, we first solicited important uncertainties from all our stakeholders, with the focus being on Veterans, family members, and clinicians who care for Veterans. For this solicitation, we had an unprecedented response from our stakeholders and community members that would be the envy of any health service and research organization! Our research team then sorted and categorized these uncertainties, contextualized within the relevant evidence landscape, for formal presentation and prioritization by our ACV annual meeting in Toronto. Through this challenging but rewarding process, the ACV identified the top research priorities for the CPCoE that will help set the scientific direction for us over the next several years. Feedback from ACV members on this process was very positive, with one member stating:

“[This was] a huge improvement in how to better assess the priorities. I loved the sub-group portion and coming back in the large group after . . .I am always leaving these meetings so fulfilled with a sense of achievement and hope for a better future for Veterans dealing with chronic pain. It is amazing knowing that what you do will make a difference. When we serve as soldiers, this is what we are driven by.”

These priorities will be of value not just for the CPCoE but also for any organization aiming to contribute to the well-being of Canadian Veterans, and civilians, living with pain. Stay tuned in 2023-2024 for more about how the CPCoE will continue to develop and utilize these priorities.

This past year also marked the growing diversity of CPCoE’s research. CPCoE has had several ‘firsts’ in executing diverse research contracts both nationally and internationally. Some key highlights include:

·  First international working group - CPCoE has collaborated with Atlas Institute for Veterans and Families and Phoenix Australia to lead a research planning process comparable to planning grants from CIHR. This project will include the development of an international, Five Eyes advisory group to develop a research proposal for evidence synthesis of high-quality clinical evidence for the management of comorbid chronic pain and PTSD. 

·  First Francophone research collaboration: CPCoE has collaborated with the Quebec Pain Research Network (QPRN) to establish the Quebec Consortium for Research on the Health of Veterans with Chronic Pain. The objective of this collaboration is to bring together Veterans, the Quebec pain research community, managers, health professionals and decision-makers to establish a long-term partnership with the CPCoE and create an efficient provincial research community to develop and propel research on Quebec Veterans suffering from chronic pain. 

·  First trauma-informed family program for Veterans: CPCoE has funded an agreement with the University of Calgary to codesign the first family intervention for military families that fosters resilience against the intergenerational transmission of pain. It will draw from evidence on the intergenerational transmission of pain, military culture and identity, resilience, and prevention and treatment approaches for pain and mental health issues in families (e.g., Cognitive-Behavioural Therapy) as well as feedback provided by Veteran families themselves. 

·  First large-scale health administrative data collaborations: CPCoE has executed an agreement with Queen’s University to create greater readiness for studies using provincial routinely collected health and social data to address the needs of Veterans and their families affected by chronic pain. This will entail mapping provincial, territorial, and national sources of routinely collected health and social data that allow for research focused on Canadian Veterans and their families. CPCoE also executed an agreement with the Institute for Clinical Evaluative Sciences (ICES) to provide a new validated algorithm to identify patients with chronic pain using primary care electronic medical record data in Canada. This will contribute to important opportunities locally, nationally, and internationally to map health status and health service utilization of Veterans, and civilians, living with pain.  

Looking forward to 2023-2024, we will see the launch of our revamped research funding process and what we hope to be major advancements in the nature and scope of the ability of researchers in Canada and internationally, to meaningfully engage Canadian Veterans living with pain, and their family members, in all aspects of the research process from conception, to design, to execution. 

Report from the Director of Research Partnerships
“The number of milestones that we have accomplished surpasses any of the expectations I had coming into this newly created position.”
Dr., Major (retired) Luc J. Hébert, fellow PT, PhD, CD Director of Research Partnerships and Chair of the Scientific Advisory Board 

I am extremely proud to have joined the CPCoE as the Director of Research Partnerships and the Chair of the Scientific Advisory Board (SAB) this past year. The number of milestones that we have accomplished surpasses any of the expectations I had coming into this newly created position. To view some of our highlights from the past fiscal year, please see below. 

1. SAB Related Activities
Adjudications and Related Tools

From July 1 to September 15, 2022, all Scientific Advisory Board (SAB) members met individually with the Chair of the SAB to exchange ideas and discuss the SAB's activities since CPCoE's inception and plan for the future. Meetings were also held with five veteran partners involved with the CPCoE and four members of the Advisory Council for Veterans (ACV). A new member also joined the SAB in the summer of 2022, Dr. Anne-Marie Pinard, full Professor at Laval University, and an anesthesiologist who works at the pain clinic at the Centre Hospitalier de Québec - Université Laval in Quebec City. She is also Director of the Medisca Leadership Chair in Chronic Pain Education.

Two SAB meetings were held on August 2, and November 2, 2022. At these meetings, more than 21 requests for research proposals were evaluated by the SAB members. On January 17, 2023, a third SAB meeting was held and under my leadership, the following documents and tools were created: the CPCoE Application Instructions, the CPCoE Application Form, and the CPCoE Rating Scale. The SAB also provided input on CPCoE’s new Researcher and Veteran Partnership Guide. These documents were thoroughly reviewed by all SAB members as well as by the CPCoE research team.

A new follow-up system has been put in place for projects that have received funding: applicants and evaluators can meet to discuss the evaluations received and any modifications to be made before the projects begin.

Creation of the CPCoE Strategic Research Collaboration Agreement (STRARCA)

The STRARCA is a short two-page document that aims to define what CPCoE means by strategic research collaboration. The objectives of having this document are to demonstrate transparency on which criteria the CPCoE makes its choices to establish strategic research collaborations, the decision to choose a research collaborator and to ensure that the choices of collaborations are linked to the priorities established by the ACV. The objective of using such a document is also to have a more centralized decision process. With a centralized process, all decisions are made in the same way by all members of the research team and are based on criteria that are related to the mandate and mission of CPCoE.

2. Research Collaborations 
Quebec Pain Research Network (QPRN) and CPCoE

Between July 2022 and March 2023, several meetings took place with the QPRN Direction. Finally, a collaboration agreement was signed between QPRN and CPCoE. This partnership has allowed the QPRN to create a Quebec consortium for research on the health of military personnel and veterans with the objective of bringing together veterans, members of the Quebec pain research community, managers, health professionals and decision-makers to establish a long-term partnership with the CPCoE and create an efficient provincial research community to develop and propel research on veterans suffering from chronic pain.

Canada's first University Chair for Canadian veterans
Since fall 2022, I have been in discussions with the Université Laval and Dr. Anne-Marie Pinard to set up a partnership between the Université Laval and the CPCoE to establish a Chair in Educational Leadership for Canadian Veterans.  The ambitious goal of the Canadian Veterans Leadership Chair in Education is to improve the care of veterans living with chronic pain through enhanced student training, tools for healthcare professionals and resources dedicated to the individuals themselves and their loved ones. The Chair's activities aim to develop an adapted and coherent set of awareness, training, support, and self-management resources that meet the specific needs of Veterans. The establishment of this Chair is progressing rapidly, and this Chair could see the light of day as early as Fall 2023.

Collaboration to create a research infrastructure at l’Hôpital Ste-Anne
Ste. Anne's Hospital is located in Sainte-Anne-de-Bellevue, Quebec, Canada. It mainly serves Canadian Forces Veterans and specializes in long-term care and geriatrics. This hospital’s complex comprises one in-patient operational stress injury clinic, the Residential Treatment Centre for Operational Stress Injuries (RTCOSI) and one outpatient Operational Stress Injury clinic, located at Sainte Anne's Hospital. Discussions and meetings between members of the management of l’Hôpital Ste-Anne and myself have led to agreement on a common basis for developing a new collaboration between this establishment and CPCoE, with the aim of developing a research infrastructure, through the future establishment of an on-site research coordinator. This project is also being carried out in partnership with the QPRN. 

QPRN retreat
On January 27-29, 2023, I attended the QPRN retreat in Sherbrooke, Quebec. This gave me the opportunity to introduce and present the CPCoE to clinicians and researchers and to strengthen the CPCoE connections. It was also an opportunity for me to announce CPCoE's upcoming calls for research proposals for the 2023 competition. During that retreat, I also met with members of the Quebec Network of junior pain investigators to promote our Capacity Building Initiatives (CBI’s).

3. Networking, Representation and Advocacy 
This year, we announced The Most Painful Podcasts in French. I worked with Tom Hoppe, the English podcast host, Veteran partner and ACV member in the production and promotion of our French podcast. In total, I hosted three episodes. The first being a transitional episode with Tom Hoppe that covered how our own civilian culture can impact our military identity. The next two episodes featured a physiotherapist who treats Veterans and then a Veteran himself.

During my participation in the QPRN members' retreat in January 2023, I completed two other podcasts in French: the first was on Discovering QPRN members, theme of LJ Hébert's research on the military and veterans, and the second was Who are the Canadian veterans?

Looking back on this list of accomplishments, I couldn’t be prouder of the members of the Scientific Advisory Board and the Research Team. The hard work and determination of these individuals made it easy for me to carry out these momentous tasks.

I look forward to improving our existing research collaborations and to creating new collaborations with organizations that have the same goal in mind as the CPCoE; to improve the lives of Canadian Veterans and their families, living with chronic pain.

2022-2023 Research

The Chronic Pain Experiences of Military Personnel, Recently Retired or Discharged Veterans, and Healthcare Providers: A Systematic Review and Qualitative Meta-Synthesis

Toronto Methodologists Corp
Dr. Umair Majid

Integrating Canadian Veteran needs in identifying effective self-education tools for medical cannabis use in chronic pain

University of Waterloo
Dr. Feng Chang

Specifications for an evidence-based, Veteran-informed decision aid to support Canadian Armed Forces Veteran engagement in physical activity and exercise

Western University
Dr. Joy MacDermid

Comparative benefits and harms of perioperative interventions to prevent chronic pain in Veterans after musculoskeletal surgery: A systematic review and network meta-analysis of randomized trials

Dr. Behnam Sadeghirad

Chronic Pain in Mental Health Treatment-Seeking Canadian Armed Forces Veterans

Lawson Health Research Institute
Dr. J. Don Richardson

Media Knowledge Mobilization Project

Douglas Research Centre: McGill University
Dr. Robert Whitley

Building capacity in studying the health and wellbeing of Veterans and their families using provincial, routinely collected health and social data

Queen’s University
Dr. Alyson Mahar

Exploring factors associated with chronic pain among Canadian Veterans

McMaster University
Dr. Jason Busse

Co-development of a family program to break the intergenerational transmission of pain in Canadian Veteran families

University of Calgary
Dr. Melanie Noel

A holistic approach including sound therapy and cardiac coherence for the management of chronic pain and tinnitus in Canadian Veterans

Université Laval
Dr. Philippe Fournier

CPCoE-QPRN Collaborative Model: Quebec Consortium for Research on the Health of Veterans with Chronic Pain

Université de Sherbrooke
Dr. Hélène Beaudry

Development and validation of a chronic pain case definition using primary care electronic medical records

Institute for Clinical Evaluative Sciences (ICES)
Dr. Liisa Jaakkimainen

Pain and PTSD International Collaboration

Phoenix Australia
Dr. Meaghan O’Donnell
2022-2023 Capacity Building Initiatives

The CPCoE has created Capacity Building Initiatives (CBIs) to build capacity in the field of Veterans’ chronic pain research. The CBIs support Canadian graduate students completing relevant research at the Master’s or Doctoral level. By investing in these students, CPCoE is helping to grow the next generation of researchers who will contribute to improving the well-being of Canadian Armed Forces Veterans, and their families, suffering from chronic pain.

One of CPCoE’s CBIs is dedicated to a founding member of the Advisory Council for Veterans, François Dupéré, who passed away on 20 January 2021.  François was an inspiration as a Veteran and as a human being.  To preserve his legacy as an advocate for resiliency within the Veterans’ community, CPCoE established a specific CBI in his honour to fund the research of a new Francophone Master’s student on a yearly basis.

Université Laval

Gabrielle Leblanc-Huard

The impact of chronic pain on social functioning of young adults transitioning from pediatric to adult care

This project aims to identify similarities and differences in the transition of young adults and Veterans living with chronic pain and present the material developed in this study so that they can be transposed to future research on Veterans and generate both spin-offs and research.

McMaster University

Ronessa Dass

Understanding the experience and impacts of brain fog in Veterans with chronic pain

The project aims to obtain an understanding of the experience of brain fog in Veterans with and without chronic pain, including symptoms, impact on functional activities, and potentially modifiable factors; 2) Determine differences in SGBA+ groups including sex, gender, ethnicity, and socioeconomic status; and 3) examine differences in performance on standardized evaluations and experiences reported in the focus group context.

Audiences / Stakeholders
Veterans and Families
Clinicians at Interdisciplinary Pain Clinics
Veterans Affairs Canada (VAC) and the Department of National Defence (DND)
Atlas Institute for Veterans and Families
Canadian Institute for Military and Veteran Health Research (CIMVHR)
CPCoE Board of Directors
Knowledge Mobilization

The CPCoE collaborates with funded researchers to support the development and dissemination of Knowledge Mobilization resources.  

Recent examples: 
·  Information Sheet for Veterans Affairs Canada (VAC) Case Managers
   ·  This handout contains information about the CPCoE, chronic pain, and interdisciplinary care and was shared with VAC case managers via: 
·  A newsletter sent to case managers through VAC 
     ·  Physical copies distributed at three conferences 
     ·  Physical copies sent to 33 local VAC offices 
·  What Makes Veteran Patients Unique: A resource for clinicians
     ·  This resource was created for clinicians to generate awareness about rates of chronic pain and other unique factors related to the Veteran experience. 
     ·  This resource was shared via: 
          §  Meetings with the CPCoE’s Knowledge Mobilization Champion Group 
          §  Physical copies distributed at the CPCoE’s Stakeholder Conference in Montréal 
          § Physical copies distributed at other conferences and electronically sent to clinicians and researchers upon request

Knowledge Mobilization Champion Group

The Knowledge Mobilization Champion Group kicked off in June 2022. This Group is comprised of 11 clinicians from the interdisciplinary pain clinic network as well as Veterans and CPCoE staff. The Group now meets bimonthly to learn from researchers about CPCoE-funded projects related to Veterans and chronic pain. The Group also serves as a forum for clinicians to share best practices for treating pain and caring for Veteran patients. In addition, KM products (e.g., infographics, videos, research summaries, etc.) are often shared with members to generate discussion about the potential use of these products to increase awareness, share knowledge, and inform clinical practice.

Framework for Evaluating KM Activities 

·  Developed a framework for evaluating KM activities and outputs that fall into four domains, each with a specific objective.  
·  The framework was developed through: 
   ·  Conducting an environmental scan of KM evaluation or research impact frameworks that could be adapted for the CPCoE’s KM goals 
   ·  Consultation with other organizations and experts

Domains for Measuring KM Efforts


Develop products that make CPCoE research findings accessible and easy to use for target audiences.


Engage researchers, clinicians, Veterans, and other knowledge users in activities that help them learn about and use CPCoE research and knowledge.


Develop and leverage collaborative relationships with stakeholders to contribute to and share CPCoE research.


Use efficient communication channels that highlight and share the work of the Centre with a broad range of local, provincial, national and international stakeholders.

For each objective, a list of specific items was developed to evaluate and indicators to track progress.

The Most Painful Podcast

This podcast covers all aspects of chronic pain by presenting evidence-based information that provides better insight into chronic pain. Recent Government of Canada research found that Veterans are twice as likely to suffer from chronic pain compared to others in the Canadian population. We aim to investigate how this impacts Veterans and their families. We explore topics such as cannabis and psychedelics; do they help treat chronic pain? We also investigate back surgery, military identity and what military and professional athletes have in common with identity. The evidence-based information on the show will help Veterans, clinicians, researchers, and anyone suffering from chronic pain. It is a 360-degree approach to education on chronic pain.

Total Episodes
French Episodes

The Most
Painful Podcast

Produced by Story Studio Network

Unique Website Visitors
Email Subscribers
Facebook Likes
Twitter Followers
Instagram Followers
Linkedin Followers
Fiscal Year 2022-2023
VAC Contribution Agreement
$ 4,528,497
Research & Informatics
$ 830,413
$ 584,359
$ 3,113,725
$ 4,528,497

Chronic Pain Centre of Excellence for Canadian Veterans

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