Impact stories

Impact is defined as an effect on, change or benefit to the economy, society, culture, public policy or services, health, research, the environment or quality of life, beyond academia. We are expected to report our 'impact stories' in our NIHR annual report.

Please see below for some of our top impact stories from recent years.

Do you have an impact story to share?

Have you changed your clinical practice in response to the evidence in a PaPaS review?

Has a PaPaS review helped you to make a decision about health care?

We'd love to hear about it, so please let us know!


Top PaPaS Impact Stories


Psychological interventions for chronic pain (excluding headache) in adults

In August 2020 we published an update of our review, Psychological therapies for the management of chronic pain (excluding headache) in adults (available in the Cochrane Library here), to include an additional 41 studies (6255 participants). The updated review includes 75 studies in total (9401 participants at treatment end).

Evidence of impact

We coordinated a dissemination plan with the author team and Cochrane’s KT team in order to disseminate the evidence as widely as possible. See some of the resources available below.


Chronic pain in children and adolescents

We were awarded an NIHR Programme Grant (2014-17) (see NIHR Programme Grant 2014-17) to address the unmet need of chronic pain. Part of the grant was to produce a series of seven reviews on chronic pain in children and adolescents.

  1. Opioids for cancer-related pain in children and adolescents (Wiffen PJ, Cooper TE, Anderson A-K, Gray AL, Grégoire M-C, Ljungman G, Zernikow B. Opioids for cancer-related pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD012564. DOI: 10.1002/14651858.CD012564.pub2)
  2. Non-steroidal anti-inflammatory drugs (NSAIDs) for cancer-related pain in children and adolescents (Cooper TE, Heathcote LC, Anderson B, Grégoire M-C, Ljungman G, Eccleston C. Non-steroidal anti-inflammatory drugs (NSAIDs) for cancer-related pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD012563. DOI: 10.1002/14651858.CD012563.pub2)
  3. Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents (Eccleston C, Cooper TE, Fisher E, Anderson B, Wilkinson NMR. Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD012537. DOI: 10.1002/14651858.CD012537.pub2)
  4. Antiepileptic drugs for chronic non-cancer pain in children and adolescents (Cooper TE, Wiffen PJ, Heathcote LC, Clinch J, Howard R, Krane E, Lord SM, Sethna N, Schechter N, Wood C. Antiepileptic drugs for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD012536. DOI: 10.1002/14651858.CD012536.pub2)
  5. Antidepressants for chronic non-cancer pain in children and adolescents (Cooper TE, Heathcote LC, Clinch J, Gold JI, Howard R, Lord SM, Schechter N, Wood C, Wiffen PJ. Antidepressants for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD012535. DOI: 10.1002/14651858.CD012535.pub2)
  6. Paracetamol (acetaminophen) for chronic non-cancer pain in children and adolescents (Cooper TE, Fisher E, Anderson B, Wilkinson NMR, Williams DG, Eccleston C. Paracetamol (acetaminophen) for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD012539. DOI: 10.1002/14651858.CD012539.pub2)
  7. Opioids for chronic non-cancer pain in children and adolescents (Cooper TE, Fisher E, Gray AL, Krane E, Sethna N, van Tilburg MAL, Zernikow B, Wiffen PJ. Opioids for chronic non-cancer pain in children and adolescents. Cochrane Database of Systematic Reviews 2017, Issue 7. Art. No.: CD012538. DOI: 10.1002/14651858.CD012538.pub2)

These reviews identified a lack of RCTs in this topic area: most had no RCTs, and others only included one or two RCTs. 

Evidence of impact

  • After completion of the Programme Grant, the NIHR awarded us some funds to hold a dissemination event. Dr Emma Fisher and Professor Christopher Eccleston planned the event for summer 2018, and invited a small group of influential individuals from policy, funding, charities, researchers and clinicians to pinpoint the gaps in paediatric pain research and generate ideas on how best to move the field forwards. The event was sponsored by PaPaS, the NIHR, Arthritis Research UK, Wellcome Trust and The European Pain Federation.
  • Emma worked with the Cochrane Knowledge Translation team on promotion of the event before, during and after. A summary of the event is published on the Cochrane website here.
  • The primary outcome of this event was to get people talking about this area of research and practice again, and hopefully ignite funding resources in the area. Second, we wanted to generate ideas about how to move this field forwards and how Cochrane could help with that. The round table discussions and feedback to the panel certainly helped with this. Further, we had a tentative offer from a major journal to write some prioritization papers that we are now pursuing (due to be submitted in 2019 - *see below for update*), which will be impactful in disseminating this message to the field and setting the research agenda for the next 5 - 10 years.
  • Dr Rebecca Abbott, Senior Research Fellow at NIHR CLAHRC South West Peninsula, University of Exeter Medical School, attended the event and published a blog here.

*On the 20th June 2019, we published an overview review in the PAIN Journal on the efficacy of pharmacological interventions for children with chronic pain and cancer-related pain. This builds on the earlier work we have done in this area, and led to a launch of the following resources:

Follow the latest Tweets (hashtag #timeforchange): @EmmaFisher1@CochranePaPaS@Cochranecollab

*In December 2020, the WHO published Guidelines on the management of chronic pain in children: access here. Our Cochrane Reviews contributed to the guideline and Dr Emma Fisher led the review of effectiveness.


More details are available on our dedicated webpage Chronic Pain in Children - Time for Change.


Paracetamol and pain

In August 2016, senior editor and author, Professor Andrew Moore, published a blog on ‘Evidently Cochrane’ on the topic of paracetamol. The blog was requested as a result of Andrew’s article in BMJ (Moore RA, Moore N; Paracetamol and pain: the kiloton problem; Eur J Hosp Pharm 2016;23:187-188; http://ejhp.bmj.com/content/23/4/187).

The blog was widely read and shared, and led to several subsequent publications. The blog was based on our Cochrane review:

Moore RA, Derry S, Aldington D, et al. Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev 2015;9:CD008659

It was also informed by the following non-Cochrane articles by PaPaS members:

  • Moore A, Derry S, Eccleston C, et al. Expect analgesic failure; pursue analgesic success. BMJ 2013;346:f2690.
  • Moore RA, Derry S, Wiffen PJ, et al. Overview review: Comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions. Eur J Pain 2015;19:1213-23.
  • Moore RA, Straube S, Aldington D. Pain measures and cut-offs - 'no worse than mild pain' as a simple, universal outcome. Anaesthesia 2013;68:400-12.

Access the blog and full list of references online http://www.evidentlycochrane.net/paracetamol-widely-used-ineffective/

Evidence of impact


Breastfeeding for procedural pain

We worked with the Cochrane External Affairs Department (CEAD) to disseminate our new review: Harrison D, Reszel J, Bueno M, Sampson M, Shah VS, Taddio A, Larocque C, Turner L. Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.: CD011248. DOI: 10.1002/14651858.CD011248.pub2.

Evidence of impact


Fibromyalgia guidelines

Reviews by Winfried Hauser (WH), PaPaS author and editor, contributed to the development and updating of fibromyalgia guidelines, for which WH was on the panel. 

Note that the last three reviews were produced by Cochrane Musculoskeletal Group; in January 2016 they were transferred to PaPaS to complete the update as it was agreed the topic was better suited to our scope.

Evidence of impact

WH is a member of the steering committee of the update of the European League Against Rheumatism (EULAR) recommendations on the management of FM which was published recently (Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, Choy E, Kosek E, Amris K, Branco J, Dincer F, Leino-Arjas P, Longley K, McCarthy GM, Makri S, Perrot S, Sarzi-Puttini P, Taylor A, Jones GT. EULAR revised recommendations for  the management of fibromyalgia. Ann Rheum Dis. 2017 Feb;76(2):318-328). The literature search focussed on systematic reviews (with or without meta-analysis) concerned with the management of  fibromyalgia including the Cochrane Library. The recommendations for some of the key recommendations of the guidelines (cognitive behavioral therapies, aerobic exercise, duloxetine, pregabalin and milnacipran) were based on Cochrane reviews.

WH is also the head of the steering committee of the German interdisciplinary guidelines on fibromyalgia syndrome. The first version was published in 2008 and was updated in 2012 and 2017. For the recent update (www.awmf.org/leitlinien/detail/ll/145-004.html), a literature search for systematic reviews of randomized, controlled trials for FM was run from December 2010 to May 2016 in the Cochrane library, MEDLINE, PsycINFO and Scopus databases. The strength of recommendations was achieved by multiple step formalized procedures to reach a consensus. The recommendations for some of the key recommendations of the guidelines (cognitive behavioral therapies, exercise (aerobic exercise, strength training, duloxetine, pregabalin and milnacipran) were based on Cochrane reviews.


Olanzapine for cancer-related nausea and vomiting

This Cochrane Review was published on 25 September 2018 (Olanzapine for the prevention and treatment of cancer‐related nausea and vomiting in adults; Sutherland  A, Naessens  K, Plugge  E, Ware  L, Head  K, Burton  MJ, Wee  B. Cochrane Database of Systematic Reviews 2018, Issue 9. Art. No.: CD012555. DOI: 10.1002/14651858.CD012555.pub2).

Evidence of impact

  • The Altmetrics score reached 50 by 2 October 2018. At March 2019, it was 77. For comparison, our median Altmetrics score for all PaPaS reviews in 2017 was 32.
  • The lead author, Sutherland, presented the review at the Oxford Advanced Pain and Symptom Management Course in 2018. The course runs on four occasions and she received very positive feedback. Sutherland used Turning Point to capture the views of the audience on the use of olanzapine as an anti-emetic, which showed that the review appeared to have altered practitioners’ views already. 
  • Andrew Davies is both the Association for Palliative Medicine (APM) and The Multinational Association of Supportive Care in Cancer (MASCC) president (correct in 2018) and the authors discussed dissemination with him. Davies informed the team that Andrew Dickman planned to present olanzapine at the Guildford Symptom Control course to highlight it to a wider UK audience.
  • Evidently Cochrane requested a blog, and the authors planned to format it as a discussion between Mary Miller at Sobell House, Oxford, and another WHO collaboration site in India where one of the trialists is based. The author team also managed to do a video link-up teaching session with him in 2018.
  • Reuters Health USA requested an interview with the lead author for an article highlighting the review.
  • Sutherland presented the review at the Hospice UK conference, November 2018.
  • Review submitted for the Twycross Prize at the APM conference, March 2019.