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

Objective With the increasing societal awareness of the prevalence and impact of acutepain, there is a need to develop an acutepain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acutepain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acutepain. 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 acutepain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acutepain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM AcutePain 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 acutepain conditions. Perspective The ACTTION-APS-AAPM AcutePain Taxonomy (AAAPT) is a multidimensional acutepain classification system designed to classify acutepain 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 acutepain, despite the advent of modern multimodal analgesic strategies. Mismanaged acutepain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acutepain 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, acutepain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acutepain mechanisms poorly differentiates between acuteand chronic pain and is often insufficient to distinguish among many types of acutepain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acutepain conditions.