Quality Standard Details
Chronic Pain: Care for Adults, Adolescents, and Children
- Publication Date
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2019-May-01
- Status
- Published
- Topic Area
- Pain
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Chronic pain is common and can significantly affect quality of life, including the ability to work or attend school. Some estimates suggest that as many as one in five Canadians live with chronic pain. About one-half of people with chronic pain report experiencing the condition for more than 10 years. In Ontario, the average annual extra cost of chronic pain to the health care system is estimated to be 51% more than for a matched person with similar morbidity and demographic characteristics but without chronic pain.
Chronic pain can be challenging to assess and manage because of the variety of underlying conditions, the relative lack of effective treatments, and the different ways people are affected. While most people with chronic pain are able to receive their care from their primary care provider, some will also require periodic access to an interprofessional pain program or to specialist care. Access to specialized pain care varies across Ontario.
This quality standard addresses care for people with chronic pain lasting longer than 3 months, and where any signs of serious underlying pathology (i.e., “red flags,” such as cancer, infection, or fracture) or other treatable conditions requiring medical or surgical management have been ruled out. It addresses care for adults, adolescents, and children, but excludes infants. It applies to care for chronic pain delivered in outpatient settings, including primary care, community pain clinics, and interprofessional pain programs.
This quality standard does not specifically address headache, pain from active cancer, or pain experienced during end of life. See Health Quality Ontario’s quality standards Palliative Care and Opioid Prescribing for Chronic Pain for quality statements related to palliative care and the use of opioids for chronic pain.
Quality Standard in Brief
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Quality Statement 1: Comprehensive Assessment
People with chronic pain receive a comprehensive assessment that includes consideration of functional status and the social determinants of health.
Quality Statement 2: Setting Goals for Pain Management and Function
People with chronic pain are encouraged to set goals for pain management and improved function. They regularly evaluate these goals with their health care professionals.
Quality Statement 3: Supported Self-Management and Education
People with chronic pain are offered education and are encouraged and supported to access self-management resources or programs as part of a long-term management strategy.
Quality Statement 4: Physical Activity
People with chronic pain are encouraged and supported to engage in regular physical activity.
Quality Statement 5: Physically Based Interventions
People with chronic pain are encouraged and supported to engage in physically based interventions.
Quality Statement 6: Therapeutic Exercise
People with chronic pain are encouraged and supported to engage in therapeutic exercise.
Quality Statement 7: Pharmacotherapy
People with chronic pain are offered non-opioid pharmacotherapies as first-line treatment for chronic pain. Medications are regularly reviewed for effectiveness in meeting goals for pain management and improved function.
Quality Statement 8: Psychologically Based Interventions
People with chronic pain are offered psychological assessment and appropriate psychologically based interventions.
Quality Statement 9: Psychosocial Supports
People with chronic pain, their families, and their caregivers are offered psychosocial supports that consider their emotional, social, cultural, cognitive, accessibility, or spiritual needs. Psychosocial supports may include traditional knowledge, medicines, and healing practices for chronic pain, where appropriate.
Quality Statement 10: Interventional Management of Chronic Pain
People with chronic pain are offered interventional management, when clinically indicated, in combination with other strategies and interventions as part of an interprofessional approach to chronic pain management.
Quality Statement 11: Access and Referral to an Interprofessional Chronic Pain Program
People whose quality of life is significantly impacted by their chronic pain are referred by their primary care provider to an interprofessional pain program. They are seen for a first appointment within 3 months of referral.
Quality Statement 12: Transitions and Coordination of Care
People with chronic pain receive timely and collaborative care during and after health care transitions.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
If you would like to receive these resources, please send us a message using our contact form:
- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Tools to support patient care
- Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
