COVID-19 and Mental Health (CMH) Initiative: Research

Rapid Evidence and Gap Map of Virtual Care Solutions for Youth and Families to Mitigate the Impact of the COVID-19 Pandemic on Pain, Mental Health and Substance Use

Key Messages

  • Virtual care is underutilized. Guidance and evidence exists and should be used where available to inform selection and implementation of virtual care best practices for youth with chronic pain and their families.
  • There is a need for increased standardization of implementation and integration of virtual solutions into clinical care.
  • Opportunities exist to further leverage stepped care virtual solutions to improve support for youth with chronic pain and their families.

Lay Summary

Findings from our knowledge synthesis revealed guidance for leveraging and implementing virtual care, selecting virtual care platforms, and questions in need of further consideration when using virtual care to support youth with chronic pain and their families.

  1. Leveraging Virtual Care
    Virtual care for youth with chronic pain and their families:
    • is acceptable, reasonable, and effective
    • increases access to care (particularly in rural or remote areas)
    • is underutilized (especially for real-time symptom assessment and psychological treatment)
  2. Implementing Virtual Care
    Virtual care for youth with chronic pain and their families should:
    • be freely available across all technologies (telephone, apps, websites, videoconference)
    • include training, terms of use, and guidelines for health professionals, youth and families
    • use secure infrastructure (encrypted, password protected, authorized access)
    • be developmentally appropriate
    • meet ethical standards of care
    • be transparent in communication (therapist vs. computer-generated messaging)
  3. Creating or Selecting Virtual Care Platforms
    Virtual care for youth with chronic pain and their families should:
    • be user-friendly and acceptable to youth and families
    • be backed by science
    • involve youth, families, and health professionals in their development
    • be individualized or customizable
    • be comprehensive in terms of pain management (address pharmacological, psychological, and physical strategies)
    • use multimedia content (videos, text, images)
    • meet accessibility standards
    • be able to integrate social and peer support
  4. Remaining Gaps About Virtual Care
    Virtual care for youth with chronic pain and their families requires:
    • standardized practice guidelines for implementation and evaluation
    • evidence showing its effectiveness for all symptoms or concerns identified by youth and families
    • knowledge about its limitations and suitability for all aspects of care (such as physical exam)
    • consideration of potential harms and impact on therapeutic relationship
    • strategies to enhance engagement
    • integration into existing clinical care pathways and face-to-face care

**Detailed research priorities for virtual care for individuals with chronic pain during the COVID-19 pandemic are outlined in Eccleston et al. (2020)

Keywords

  • Children
  • Youth
  • Virtual care
  • Chronic pain
  • Mental health
  • Substance use
  • Guidelines
  • Best practices
  • Stepped care

Author(s)

  • Nominated Principal Applicant: Kathryn A. Birnie, PhD RPsych, Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary; Assistant Scientific Director, Solutions for Kids in Pain
  • Melanie Noel, PhD RPsych, Department of Psychology, University of Calgary
  • Jennifer Stinson, PhD RN, Child Health Evaluative Sciences, The Hospital for Sick Children; Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto
  • Isabel Jordan, Youth Patient Partner
  • Evie Jordan, Parent Patient Partner
  • Justina Marianayagam, BHSc, Youth Patient Partner; Medical Student, Northern Ontario School of Medicine
  • Diane Lorenzetti, PhD, Health Sciences Library & Department of Community Health Sciences, University of Calgary
  • Tieghan Killackey, PhD RN, Postdoctoral Fellow (July 2020), Child Health Evaluative Sciences, The Hospital for Sick Children
  • Fiona Campbell, MD FRCA, Department of Anesthesiology & Pain Medicine, The Hospital for Sick Children; University of Toronto, Co-chair Canadian Pain Task Force
  • Paul Arnold, MD PhD FRCPC, Departments of Psychiatry & Medical Genetics, University of Calgary
  • Chitra Lalloo, PhD, Child Health Evaluative Sciences, The Hospital for Sick Children
  • Alexandra Neville, MSc, PhD Student, Department of Psychology, University of Calgary
  • Maria Pavlova, MSc, PhD Student, Department of Psychology, University of Calgary

For more information, please contact: Kathryn Birnie, kathryn.birnie@ucalgary.ca.

Related Syntheses

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Population

Children, Youth and Families

Language

To ensure the rapid dissemination of this critical information, information is published in the language in which it was submitted. Please contact us for French or English translations.

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