Multiprofessional practice in the implementation of the pain protocol: a systematic review of scientific evidence
DOI:
https://doi.org/10.36557/2674-9432.2026v5n6p470-487Keywords:
Pain management, Multiprofessional team, Clinical protocols, Healthcare, Systematic review, Patient safetyAbstract
Introduction: Pain is a complex, multifactorial, and unpleasant sensory and emotional experience that requires continuous interprofessional interventions for its management. Although clinical pain protocols standardize assessment and treatment routines, their effectiveness intrinsically depends on the engagement, coordination, and synergy of the multiprofessional team. Objective: To analyze and synthesize scientific evidence regarding the role of the multiprofessional team in the implementation, adherence, and clinical impact of structured pain management protocols in healthcare settings. Methodology: A systematic review conducted in accordance with PRISMA 2020 guidelines. The literature search was performed across PubMed/MEDLINE, Scopus, Web of Science, Embase, BVS/LILACS, SciELO, and CINAHL databases, covering primary studies published between 2014 and 2024. Methodological quality and risk of bias were assessed using Joanna Briggs Institute (JBI) tools. Results and discussion: Fourteen primary studies were included (randomized clinical trials, quasi-experimental before-and-after studies, prospective and retrospective cohorts, and case-control studies), conducted in nine countries, including Brazil. The implementation of protocols managed by interprofessional teams was associated with reduced pain scores and opioid consumption, shorter time to initial analgesia, reduced hospital length of stay and duration of mechanical ventilation, lower incidence of opioid-related gastrointestinal adverse events, and increased patient satisfaction. Key disciplinary contributions include systematic screening and reassessment by nursing staff, pharmacotherapeutic individualization by physicians and clinical pharmacists, and non-pharmacological interventions led by physical therapy, occupational therapy, and psychology. Final Considerations: Consolidating a multidisciplinary approach within pain protocols optimizes care outcomes and strengthens the patient safety culture, while critically depending on institutional support and continuing health education.
Downloads
References
AROMATARIS, E.; MUNN, Z. (ed.). JBI Manual for Evidence Synthesis. Adelaide: JBI, 2020. DOI: https://doi.org/10.46658/JBIMES-20-01
AUYONG, D. B. et al. Reduced length of hospitalization in primary total knee arthroplasty patients using an updated Enhanced Recovery After Orthopedic Surgery (ERAS) pathway. The Journal of Arthroplasty, v. 30, n. 10, p. 1705-1709, 2015. DOI: https://doi.org/10.1016/j.arth.2015.05.007
BESEN, B. A. M. P. et al. Implantação de um protocolo de manejo de dor e redução do consumo de opioides na unidade de terapia intensiva: análise de série temporal interrompida. Revista Brasileira de Terapia Intensiva, v. 31, n. 4, p. 447-455, 2019. DOI: https://doi.org/10.5935/0103-507X.20190085
CHEN, J. et al. Impact of a clinical pharmacist-led guidance team on cancer pain therapy in China: a prospective multicenter cohort study. Journal of Pain and Symptom Management, v. 48, n. 4, p. 500-509, 2014. DOI: https://doi.org/10.1016/j.jpainsymman.2013.10.015
CHEN, K.-J. et al. Effectiveness of collaboration between oncology pharmacists and anaesthesiologists for inpatient cancer pain management: a pilot study in Taiwan. Journal of International Medical Research, v. 49, n. 11, p. 1-10, 2021. DOI: https://doi.org/10.1177/03000605211055415
DING, H. et al. Multidisciplinary intervention incorporating pharmacists in management of opioid-naïve patients with moderate to severe cancer pain. European Journal of Cancer Care, v. 29, n. 3, e13225, 2020. DOI: https://doi.org/10.1111/ecc.13225
GOLD, J. I.; MAHRER, N. E. Is virtual reality ready for prime time in the medical space? A randomized control trial of pediatric virtual reality for acute procedural pain management. Journal of Pediatric Psychology, v. 43, n. 3, p. 266-275, 2018. DOI: https://doi.org/10.1093/jpepsy/jsx129
KEFYALEW, M. et al. Improving the time to pain relief in the emergency department through triage nurse-initiated analgesia: a quasi-experimental study from Ethiopia. African Journal of Emergency Medicine, v. 14, n. 3, p. 174-180, 2024. DOI: https://doi.org/10.1016/j.afjem.2024.06.004
MITRA, S. et al. Does an acute pain service improve the perception of postoperative pain management in patients undergoing lower limb surgery? A prospective controlled non-randomized study. Journal of Anaesthesiology Clinical Pharmacology, v. 36, n. 2, p. 187-194, 2020. DOI: https://doi.org/10.4103/joacp.JOACP_104_19
NEUNHOEFFER, F. et al. Nurse-driven pediatric analgesia and sedation protocol reduces withdrawal symptoms in critically ill medical pediatric patients. Paediatric Anaesthesia, v. 25, n. 8, p. 786-794, 2015. DOI: https://doi.org/10.1111/pan.12649
OLSEN, B. F. et al. Results of implementing a pain management algorithm in intensive care unit patients: the impact on pain assessment, length of stay, and duration of ventilation. Journal of Critical Care, v. 36, p. 207-211, 2016. DOI: https://doi.org/10.1016/j.jcrc.2016.07.011
PAGE, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, v. 372, n. 71, 2021. DOI: https://doi.org/10.1136/bmj.n71
RAJA, S. N. et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain, v. 161, n. 9, p. 1976-1982, 2020. DOI: https://doi.org/10.1097/j.pain.0000000000001939
SCHNEIDER, S. et al. Effect of an interdisciplinary inpatient program for patients with complex regional pain syndrome in reducing disease activity: a single-center prospective cohort study. Pain Medicine, v. 25, n. 7, p. 452-461, 2024. DOI: https://doi.org/10.1093/pm/pnae021
SKÚLADÓTTIR, H. et al. Pain rehabilitation's effect on people in chronic pain: a prospective cohort study. International Journal of Environmental Research and Public Health, v. 18, n. 19, 10306, 2021. DOI: https://doi.org/10.3390/ijerph181910306
TAVARES, L. R. et al. Is the symptom of pain adequately addressed in hospitalization at Internal Medicine? Cross-sectional study. BrJP, v. 6, n. 3, p. 260-265, 2023. DOI: https://doi.org/10.5935/2595-0118.20230072-en
WORLD HEALTH ORGANIZATION. WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. Genebra: WHO, 2018. ISBN 978-92-4-155039-0. Disponível em: https://www.who.int/publications/i/item/9789241550390. Acesso em: 2 ago. 2026.
YEO, J. et al. Comparison of the analgesic efficacy of opioid-sparing multimodal analgesia and morphine-based patient-controlled analgesia in minimally invasive surgery for colorectal cancer. World Journal of Surgery, v. 46, n. 7, p. 1788-1795, 2022. DOI: https://doi.org/10.1007/s00268-022-06473-5
ZHANG, Q. et al. The impact of ERAS and multidisciplinary teams on perioperative management in colorectal cancer. Pain and Therapy, v. 14, n. 1, p. 201-215, 2025. DOI: https://doi.org/10.1007/s40122-024-00667-6
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Percilia Augusta Santana da Silva Campelo, Kecyani Lima dos Reis, Cesar Mendel Fernandes Ferreira, Bruno Antunes Cardoso, Hugo Santana dos Santos Júnior, Wanderson Thiago Santos Noleto, Keise Helaine Moreira da Silva Pinto, Francisco Alves Lima Júnior, Anderson Bentes de Lima, Vania Maria de Araújo Giaretta

This work is licensed under a Creative Commons Attribution 4.0 International License.
Você tem o direito de:
- Compartilhar — copiar e redistribuir o material em qualquer suporte ou formato para qualquer fim, mesmo que comercial.
- Adaptar — remixar, transformar, e criar a partir do material para qualquer fim, mesmo que comercial.
- O licenciante não pode revogar estes direitos desde que você respeite os termos da licença.
De acordo com os termos seguintes:
- Atribuição — Você deve dar o crédito apropriado , prover um link para a licença e indicar se mudanças foram feitas . Você deve fazê-lo em qualquer circunstância razoável, mas de nenhuma maneira que sugira que o licenciante apoia você ou o seu uso.
- Sem restrições adicionais — Você não pode aplicar termos jurídicos ou medidas de caráter tecnológico que restrinjam legalmente outros de fazerem algo que a licença permita.