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


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 (e.g., 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.

SUBMITTER: Kent ML 

PROVIDER: S-EPMC5431381 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Publications

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

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

Pain medicine (Malden, Mass.) 20170501 5


<h4>Objective</h4>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 (e.g., pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and clas  ...[more]

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