The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions

Michael L Kent; Patrick J Tighe; Inna Belfer; Timothy J Brennan; Stephen Bruehl; Chad M Brummett; Chester C Buckenmaier; Asokumar Buvanendran; Robert I Cohen; Paul Desjardins; David Edwards; Roger Fillingim; Jennifer Gewandter; Debra B Gordon; Robert W Hurley; Henrik Kehlet; John D Loeser; Sean Mackey; Samuel A McLean; Rosemary Polomano; Siamak Rahman; Srinivasa Raja; Michael Rowbotham; Santhanam Suresh; Bernard Schachtel; Kristin Schreiber; Mark Schumacher; Brett Stacey; Steven Stanos; Knox Todd; Dennis C Turk; Steven J Weisman; Christopher Wu; Daniel B Carr; Robert H Dworkin; Gregory Terman

doi:10.1016/j.jpain.2017.02.421

The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions

Michael L Kent, Patrick J Tighe, Inna Belfer, Timothy J Brennan, Stephen Bruehl, Chad M Brummett, Chester C Buckenmaier, Asokumar Buvanendran, Robert I Cohen, Paul Desjardins, David Edwards, Roger Fillingim, Jennifer Gewandter, Debra B Gordon, Robert W Hurley, Henrik Kehlet, John D Loeser, Sean Mackey, Samuel A McLean, Rosemary PolomanoSiamak Rahman, Srinivasa Raja, Michael Rowbotham, Santhanam Suresh, Bernard Schachtel, Kristin Schreiber, Mark Schumacher, Brett Stacey, Steven Stanos, Knox Todd, Dennis C Turk, Steven J Weisman, Christopher Wu, Daniel B Carr, Robert H Dworkin, Gregory Terman

Institut for Klinisk Medicin

18 Citationer (Scopus)

67 Downloads (Pure)

Abstract

OBJECTIVE: With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain.

SETTING: Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM).

METHODS: As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions.

PERSPECTIVE: The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.

CONCLUSIONS: Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.

Originalsprog	Engelsk
Tidsskrift	Journal of Pain
Vol/bind	18
Udgave nummer	5
Sider (fra-til)	479-489
Antal sider	11
ISSN	1526-5900
DOI	https://doi.org/10.1016/j.jpain.2017.02.421
Status	Udgivet - 1 maj 2017

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10.1016/j.jpain.2017.02.421Licens: CC BY-NC-ND

The ACTTION–APS–AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain ConditionsForlagets udgivne version, 382 KBLicens: CC BY-NC-ND

Citationsformater

Kent, M. L., Tighe, P. J., Belfer, I., Brennan, T. J., Bruehl, S., Brummett, C. M., Buckenmaier, C. C., Buvanendran, A., Cohen, R. I., Desjardins, P., Edwards, D., Fillingim, R., Gewandter, J., Gordon, D. B., Hurley, R. W., Kehlet, H., Loeser, J. D., Mackey, S., McLean, S. A., ... Terman, G. (2017). The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions. Journal of Pain, 18(5), 479-489. https://doi.org/10.1016/j.jpain.2017.02.421

Kent, ML, Tighe, PJ, Belfer, I, Brennan, TJ, Bruehl, S, Brummett, CM, Buckenmaier, CC, Buvanendran, A, Cohen, RI, Desjardins, P, Edwards, D, Fillingim, R, Gewandter, J, Gordon, DB, Hurley, RW, Kehlet, H, Loeser, JD, Mackey, S, McLean, SA, Polomano, R, Rahman, S, Raja, S, Rowbotham, M, Suresh, S, Schachtel, B, Schreiber, K, Schumacher, M, Stacey, B, Stanos, S, Todd, K, Turk, DC, Weisman, SJ, Wu, C, Carr, DB, Dworkin, RH & Terman, G 2017, 'The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions', Journal of Pain, bind 18, nr. 5, s. 479-489. https://doi.org/10.1016/j.jpain.2017.02.421

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abstract = "OBJECTIVE: With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain.SETTING: Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM).METHODS: As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions.PERSPECTIVE: The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.CONCLUSIONS: Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.",

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doi = "10.1016/j.jpain.2017.02.421",

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AU - Kent, Michael L

AU - Tighe, Patrick J

AU - Belfer, Inna

AU - Brennan, Timothy J

AU - Bruehl, Stephen

AU - Brummett, Chad M

AU - Buckenmaier, Chester C

AU - Buvanendran, Asokumar

AU - Cohen, Robert I

AU - Desjardins, Paul

AU - Edwards, David

AU - Fillingim, Roger

AU - Gewandter, Jennifer

AU - Gordon, Debra B

AU - Hurley, Robert W

AU - Kehlet, Henrik

AU - Loeser, John D

AU - Mackey, Sean

AU - McLean, Samuel A

AU - Polomano, Rosemary

AU - Rahman, Siamak

AU - Raja, Srinivasa

AU - Rowbotham, Michael

AU - Suresh, Santhanam

AU - Schachtel, Bernard

AU - Schreiber, Kristin

AU - Schumacher, Mark

AU - Stacey, Brett

AU - Stanos, Steven

AU - Todd, Knox

AU - Turk, Dennis C

AU - Weisman, Steven J

AU - Wu, Christopher

AU - Carr, Daniel B

AU - Dworkin, Robert H

AU - Terman, Gregory

PY - 2017/5/1

Y1 - 2017/5/1

N2 - OBJECTIVE: With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain.SETTING: Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM).METHODS: As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions.PERSPECTIVE: The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.CONCLUSIONS: Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.

AB - OBJECTIVE: With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain.SETTING: Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM).METHODS: As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions.PERSPECTIVE: The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.CONCLUSIONS: Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.

KW - Acute Pain/classification

KW - Classification/methods

KW - Humans

KW - Pain Measurement/methods

KW - Public-Private Sector Partnerships/standards

KW - Societies, Medical/standards

U2 - 10.1016/j.jpain.2017.02.421

DO - 10.1016/j.jpain.2017.02.421

M3 - Journal article

C2 - 28495013

SN - 1526-5900

VL - 18

SP - 479

EP - 489

JO - The Journal of Pain

JF - The Journal of Pain

IS - 5

ER -

The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions

Abstract

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