Table 4.

Priority interventions identified grouped by intervention theme, with total score, votes and illustrative participant’s quote for each priority intervention

Intervention themes	Total score (votes)	Quotes
Interdisciplinary continuing education
Provide multidisciplinary clinical teams with uniform, standardized continuing education program on chronic non-cancer pain (CNCP) (eg, know-how, skills)	991 (37)	“Training must address how we work together, what teamwork is and who will take the lead over the intervention. After that, the role of each individual.” [Primary care physician]
Provide standardized tools for synthesis and follow-up to be filled out by clinicians and patients to consistently transfer information in a shared language	775 (37)	“We need an interdisciplinary electronic record, accessible to diverse clinicians, interfaced.” [Pharmacist] “When patient would forget pain logbook, it would be no problem, it would be computerized.” [Pharmacist]
Enhance clinical expertise by providing a bank of information shared with all clinicians and patients (eg, website)	291 (19)	“We should have an electronic decision-support tool; 1 can’t believe we are starting again to look in the books. We need an e-library, if you’re querying arthritis, you have the latest guidelines, tools for patients etc.” [Nurse]
Interdisciplinary approach
Train care managers in pain management	442 (22)	“There should be pain management nurses in primary care. We should be able to intervene more efficaciously, and we should also involve and educate patients, remind them, and check for secondary effects.” [Nurse]
Develop an accessible and affordable approach to interdisciplinary collaboration	330(18)	“Quite often, when physicians practice in silos, they let go those patients. It goes a lot better when physicians do interdisciplinary practice, we share the follow-up of patients with multiple challenges, and thus it frees up physician time.” [Nurse]
Widen the range of professional responsibility of clinicians (other than the physician) to overcome bottlenecks and increase efficiency	313 (16)	“Shared care, physiotherapist should be able to prescribe radiographies, and certain anti-inflammatory medications. Bill 90 allows nurses to do many things.” [Physiotherapist]
Perform psychosocial assessment at the moment chronic pain is diagnosed	125(6)	“There should be a psychosocial assessment. It would allow orienting […] because psychosocial events often taint patient’s reaction to treatment or to events.” [Psychologist]
Regional expert
Identify regional experts and train them to disseminate information and support clinicians	551 (30)	“Just like we did in palliative care, we appointed a regional physician in charge, who takes on regional leadership. He reaches for expertise. There has to be regional leadership instead of saying ‘the Health Agency will do it’. The Health Agency is no one, it’s a building.” [Primary care physician]
Care path
Define roles and responsibilities of primary, secondary, and tertiary care and establish care paths to improve access to specialized resources in CNCP treatment	599 (25)	“Service corridors must be made between two departments, and be supported by both Health Agencies that have come to sit and listen to each other. One receives, one refers, and one refers back, so there must be agreements between departments.” [Primary care physician]
Self-care support
Promote the active participation of patients in their treatment through education adapted to their needs (eg, aggravating factors, self-management of pain, alternative therapies)	312(16)	“I answer [other patients’] emails. I tell them they must not stay in bed, they must continue exercise, see their doctor, and we don’t speak of curing chronic pain, we speak of soothing. The objectives must not be too high, and we still must have objectives. And you have to go smoothly with exercising so that people don’t opt out.” [Patient]
Establish a paper or web logbook for patients and clinicians	272(17)	“They are given digital instruments. They fill out a logbook of their day and their medication use. I cannot work without the patient.” [Primary care physician]
Specific guideline
Systematically assess pain as the fifth vital sign	30(2)	“People speak a lot of the four vital signs and in my opinion there should be five: pain is the fifth … Then it would be important to formalize it and to have a systematic assessment model.” [Nurse]