Chronic pain affects one in five Canadians and is a heavy burden for individuals and the health care system. Researchers at UHN’s KITE Research Institute (KITE) reviewed the impact of ECHO Pain, a chronic pain and opioid management education program for health care professionals, and identified how it has strengthened chronic pain care across Canada.
People living with chronic pain face higher health care costs, limited access to specialized care, and reduced quality of life. At the same time, the rate of opioid addiction and overdose in Canada continues to rise. Together, these challenges highlight the need for better education and support for health care providers to ensure safe and effective chronic pain management and reduce the risks associated with prescribing opioids.
To address this need, a team at UHN and Queen’s University co-developed ECHO Ontario Chronic Pain and Opioid Stewardship (ECHO Pain). This virtual, case-based health professions education program brings together a team of specialists and primary care providers to discuss real patient scenarios, share best practices, and strengthen chronic pain and opioid management skills. Between June 2014 and June 2024, the program delivered 529 sessions and engaged over 1,500 health care professionals from across Ontario, including many practising in remote communities.
Participants of ECHO Pain reported high program satisfaction and increased confidence and knowledge in both chronic pain and opioid management. When the research team evaluated prescribing patterns, ECHO-trained care providers significantly reduced opioid prescriptions compared to those who did not participate. The program also fostered a strong, interdisciplinary community where health care providers could share knowledge, skills, and resources. Its virtual format provided timely access to education for physicians working in rural, remote, and underserved communities.
The research team identified several components of the program that contributed to its success, including strong administrative support, a dedicated research and education team, and consistent engagement from the multidisciplinary program team. They also emphasized the importance of regular recruitment of participants and patient cases, and ongoing evaluation to ensure the program continues to meet the needs of health care providers.
As the program model continues to be adopted nationwide, ECHO Pain offers a promising approach to strengthening chronic pain management and equipping health care professionals with the necessary skills, resources, and community to improve care for people living with chronic pain.
Dr. Andrea Furlan, first author of the study, is a Senior Scientist at UHN’s KITE Research Institute. Dr. Furlan is also a Professor in the Department of Medicine and the Institute of Medical Science at the University of Toronto.
This work was supported by UHN Foundation, the Canadian Institutes of Health Research, the Ontario Ministry of Health and Long-Term Care, the Ontario Medical Association, and the Northern Ontario Academic Medicine Association.
Dr. Furlan has a monetized YouTube channel and receives royalties from two published books for people with chronic pain.
Furlan AD, Zhao QJ, Taenzer P, Smith AJ, Fabico R, Morgan K, Mostyn R, Flannery JF. Ten Years of ECHO Chronic Pain and Opioid Stewardship in Ontario: Impact and Future Directions. Healthcare (Basel). 2025 Dec 8. doi: 10.3390/healthcare13243203.