People with chronic pain are a high health service using population, representing a significant proportion of primary care visits, but their health service use and needs have been largely understudied. This mixed-methods study investigates experiences of accessing primary care services for people with chronic pain in British Columbia (BC), Canada.

This research programme includes a retrospective cohort study using administrative data, semistructured interviews with people with chronic pain, and triangulation of data. The aim is to support a more robust understanding of how people with chronic pain access primary care services and how this impacts other health services use. These studies emphasise the importance of lived/living experience of chronic pain through the inclusion of individuals with lived experience on the research team and study council, qualitative interviews with people with chronic pain and application of a critical disability theory lens.

We have obtained ethics approvals from the Simon Fraser University research ethics board. Population Data BC has granted access to de-identified administrative data. Study findings will be disseminated through academic outputs and through knowledge mobilisation with relevant community partners.

Administration of antibiotics before incising the skin (‘surgical antimicrobial prophylaxis’) is a critical infection prevention strategy in surgery. Extending doses of prophylaxis into the postoperative period is a common practice in cardiac surgery; however, the benefit has not been clearly established and may lead to emergence of antimicrobial resistance and patient harm. We present the protocol for a large international multicentre, adaptive, pragmatic, double-blind, three-arm, placebo-controlled, randomised, non-inferiority clinical trial to compare the incidence of surgical site infection after three different durations of postoperative surgical antimicrobial prophylaxis in patients undergoing cardiac surgery.

This adaptive, multi-arm multistage non-inferiority trial will compare intraoperative only (Arm A), to intraoperative and 24 hours (Arm B) and, to intraoperative and 48 hours (Arm C) of intravenous cefazolin and placebo as surgical antimicrobial prophylaxis in 9180 patients undergoing cardiac surgery. The adaptive design allows for potential dropping of any of the three arms if clear inferiority is indicated at any of the scheduled interim analyses. The trial will evaluate the clinical and cost-effectiveness of the three different antibiotic prophylaxis durations.

Ethics approval will be obtained at all participating sites. Results of the study will be submitted for publication in peer-reviewed journals and the key findings presented at national and international conferences. Patients and members of the public will also be involved in the dissemination and translation of the trial results.

NCT05447559.