Overview

The Centre of Excellence is the national leader in researching chronic pain in Veterans. The guiding principles for research include national and international collaboration, building upon existing strengths in Canada, and capitalizing on existing investments made by Veterans Affairs Canada (VAC). With the goal of improving Veterans’ well-being, our research findings will be used to promote evidence-based best practices that will inform our network of pain clinics, researchers, case managers, and the public.

Veteran Engagement

At the core of all Centre of Excellence activities is the principle of Veteran engagement. Consultation and engagement with Veterans, which includes an Advisory Council for Veterans (ACV) to advise on research priorities, began prior to establishing the organization and continues as a lasting priority. This ongoing engagement helps to develop a deeper and more thorough understanding of the day-to-day challenges that Veterans and their families face as a result of their experiences with chronic pain. That understanding is used to shape research to ensure that it will have a genuine, practical, and positive impact on the well-being of Veterans and their families.

Priorities

The Centre of Excellence conducted an initial qualitative study to better understand research priorities for Veterans. One-on-one interviews were conducted with Veterans across five Canadian provinces who reported living with chronic pain that began during their service. Results showed the following research priorities: prevention of chronic pain, improved coordination of chronic pain care, improving knowledge and competencies in pain management among healthcare providers, and improving chronic pain management. A cross-sectional review will commence soon to further define and rank these priorities.

Funding

The Centre of Excellence uses a competitive application process to allocate research funding. All eligible applications are reviewed by both the ACV and the Scientific Advisory Board (more information coming soon). Funding is provided through the means of a service agreement.

More information on current funding opportunities is coming soon.

Projects Underway

The Centre of Excellence is currently conducting research in the following areas:

RapidRecs

RapidRecs are a knowledge synthesis product developed for the British Medical Journal (BMJ) to quickly generate practice advisories on high interest topics.

RapidRecs will be selected to address high priority topics identified by the initial priority setting exercise and clinical needs identified by the network of interdisciplinary pain clinics and case managers.

A RapidRec on the effectiveness of Cannabis for chronic pain will be released shortly. A RapidRec about management of chronic jaw pain is also underway.

Seven Domains of Well-Being

VAC has identified Seven Domains of Well-Being that are important to facilitate understanding of Veterans’ well-being: (1) health, (2) life skills & preparedness, (3) finances, (4) social integration, (5) cultural & social environment, (6) housing & physical environment, and (7) employment or other meaningful activity.

However, VAC has not yet identified optimal instruments to measure these constructs. The Centre of Excellence will complete a series of systematic reviews to identify the optimal instruments for measuring each of the Seven Domains, which will then support future research into each of the Domains.

Following an exercise on prioritization, the ACV selected the Domain of Health as most important to research first. Research has now commenced on the topic.

Informatics Platform

An informatics platform is being created to support the collection and analysis of anonymized clinical data from the treatment of Veterans.

This clinical data will support the studies aimed at evaluating the impact of different types of pain care delivery for Veterans. In short, the aim of this project will be evidence-based recommendations based on the results of best practice across the nationwide network of clinics. The results will be shared immediately with care providers and the public to further improve care delivery for Veterans and the Canadian population. The results will also be used to re-commence the cycle and drive research forward.

Evaluation of Online Pain Services

With the rise of COVID-19, many pain services have shifted from in-person to online.

The Centre of Excellence is undertaking a research project to evaluate the effectiveness of online care. This includes: the establishment of base requirements, ease of access, challenges/barriers, e-platforms that support them, resource implications, patient satisfaction, and clinical impacts.

Education Platform

The Centre of Excellence is establishing a chronic pain self-management platform to help Veterans and their families.

The platform, built with Veteran input, will provide evidence-based, practical information about best practice pain self-management.

Institute for Clinical and Evaluative Studies (ICES) Data

ICES data incorporates all administrative healthcare utilization data in the province of Ontario.

Given that ICES data includes a Veteran identifier, the aim for this research project is to explore health issues facing Veterans in Ontario post-discharge from the Canadian Armed Forces.

Near-term Projects

The Centre of Excellence is presently initiating projects in the following areas:

Intergenerational impacts of chronic pain in Veterans
Sex/gender differences in the impact of military service
Impacts of Cannabis use in Veterans

Long-term Projects

The Centre of Excellence is preparing to seek proposals in early 2021 on the following potential topic areas:

Impact(s) of transition from the military for those with chronic pain
Impact(s) of clinical evidence and support tools at point-of-care
Longitudinal study on Veterans with chronic pain

Recent Publications

Recent articles published on the topic of chronic pain

Psychological Injury and Law

Chronic Pain: Evolution of Clinical Definitions and Implications for Practice

This paper reviews information regarding the evolution of definitions of pain terminology and pain syndromes as they relate to everyday practice for clinicians and those operating within the medicolegal judicial system, both trainees and seasoned professionals, with a focus on chronic pain.

View Article

Annals of Internal Medicine

Predictors of Prolonged Opioid Use After Initial Prescription for Acute Musculoskeletal Injuries in Adults

Opioids are frequently prescribed for acute musculoskeletal injuries and may result in long-term use and consequent harms.

View Article

Annals of Internal Medicine

Management of Acute Pain From Non–Low Back Musculoskeletal Injuries

Patients and clinicians can choose from several treatment options to address acute pain from non–low back musculoskeletal injuries.

View Article

Canadian Journal of Pain

Pain Management Program Outcomes in Veterans with Chronic Pain & Comparison with Nonveterans

This study presents evidence supporting the effectiveness of an interdisciplinary pain management program in addressing pain-related variables in Veterans and nonveterans and provides insight into how pain management is experienced differently by Veterans.

View Article

Veterans Affairs Canada

Post-traumatic stress disorder (PTSD) and war-related stress

View Article

Looking to Collaborate?

Should you wish to learn more or discuss collaboration on research projects, please e-mail research@vcp-vdc.ca.

Overview

Veteran Engagement

Priorities

Funding

Projects Underway

RapidRecs

Seven Domains of Well-Being

Informatics Platform

Evaluation of Online Pain Services

Education Platform

Institute for Clinical and Evaluative Studies (ICES) Data

Near-term Projects

Long-term Projects

Recent Publications

Psychological Injury and Law

Annals of Internal Medicine

Annals of Internal Medicine

Canadian Journal of Pain

Veterans Affairs Canada

Looking to Collaborate?

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