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Recommendations for Pain Management Research∗

        • 1.
          Definition: Define all terms (such as “new opioid prescription” or “long-term opioid use”) precisely, using criteria established by the Centers for Disease Control and Prevention (CDC) or a similar institution if possible. If a more established descriptor is not applicable to the database, explain why and clearly state the criteria for the definition used.
        • 2.
          Quantification: Quantifying opioid use in morphine milligram equivalents (MMEs) enables comparisons within the literature. As >1 conversion factor is available, state how MMEs were calculated. The CDC provides a toolkit for calculating MMEs.
        • 3.
          Population: As different groups experience pain differently, the study population (age, sex, socioeconomic, cultural) should be defined precisely. Research on sex-based differences in pain experienced and response to opioids is needed.
        • 4.
          Risk factors/predictors: Factors such as previous pain/opioid use, demographics, depression, catastrophizing, expectations, sleep disturbance, somatosensory function, physical activity, and coping ability should be studied as contributors to musculoskeletal pain and risk of opioid overuse.
        Outcomes:
        • 5.
          The key measure should be better patient-related outcomes—including a positive experience that is free of complications and excessive pain—not just number of pills taken.
        • 6.
          Distinguish among medications prescribed, obtained, and consumed. Be clear about the methods used to obtain these data and their limitations.
        • 7.
          Pain relief using alternative strategies (nonsteroidal antiinflammatory drugs [NSAIDs], ice, nerve growth factor inhibitors, psychological interventions), as opposed to elimination of opioids, should be a goal.