Pre‐implementation formative evaluation of cooperative pain education and self‐management expanding treatment for real‐world access: A pragmatic pain trial.
Objective: Cognitive behavioral therapy for chronic pain (CBT‐CP) is an evidence‐based treatment for improving functioning and pain intensity for people with chronic pain with extensive evidence of effectiveness. However, there has been relatively little investigation of the factors associated with...
| Publicado en: | Pain Practice Vol. 23; no. 4; pp. 338 - 349 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Apr2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=162995952&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 162995952 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15307085 HYN jtl: Pain Practice issn: 15307085 maglogo: Y pubinfo: dt: Apr2023 vid: 23 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 162995952 161025093 162995952 162995952 10.1111/papr.13195 162995952 ppf: 338 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Pre‐implementation formative evaluation of cooperative pain education and self‐management expanding treatment for real‐world access: A pragmatic pain trial. aug: au: Mattocks, Kristin M. LaChappelle, Kathryn M. Krein, Sarah L. DeBar, Lynn L. Martino, Steve Edmond, Sara Ankawi, Brett MacLean, R. Ross Higgins, Diana M. Murphy, Jennifer L. Cooper, Emily Heapy, Alicia A. affil: VA Central Western Massachusetts Healthcare System, Leeds Massachusetts,, USA sug: subj: Chronic Pain Therapy Cognitive Therapy Chronic Pain Education Pain Management Education Self Care Education Patient Education Practice Patterns Evaluation Physician Attitudes Evaluation Physicians, Family Health Services Accessibility Human Funding Source Formative Evaluation Research Qualitative Studies Conceptual Framework Implementation Science Geographic Factors Hospitals, Veterans Grounded Theory Interviews Thematic Analysis Referral and Consultation Professional Knowledge Telemedicine ab: Objective: Cognitive behavioral therapy for chronic pain (CBT‐CP) is an evidence‐based treatment for improving functioning and pain intensity for people with chronic pain with extensive evidence of effectiveness. However, there has been relatively little investigation of the factors associated with successful implementation and uptake of CBT‐CP, particularly clinician and system level factors. This formative evaluation examined barriers and facilitators to the successful implementation and uptake of CBT‐CP from the perspective of CBT‐CP clinicians and referring primary care clinicians. Methods: Qualitative interviews guided by the Consolidated Framework for Implementation Research were conducted at nine geographically diverse Veterans Affairs sites as part of a pragmatic clinical trial comparing synchronous, clinician‐delivered CBT‐CP and remotely delivered, technology‐assisted CBT‐CP. Analysis was informed by a grounded theory approach. Results: Twenty‐six clinicians (CBT‐CP clinicians = 17, primary care clinicians = 9) from nine VA medical centers participated in individual qualitative interviews conducted by telephone from April 2019 to August 2020. Four themes emerged in the qualitative interviews: (1) the complexity and variability of referral pathways across sites, (2) referring clinician's lack of knowledge about CBT‐CP, (3) referring clinician's difficulty identifying suitable candidates for CBT‐CP, and (4) preference for interventions that can be completed from home. Conclusions: This formative evaluation identified clinician and system barriers to widespread implementation of CBT‐CP and allowed for refinement of the subsequent implementation of two forms of CBT‐CP in an ongoing pragmatic trial. Identification of relative difference in barriers and facilitators in the two forms of CBT‐CP may emerge more clearly in a pragmatic trial that evaluates how treatments perform in real‐world settings and may provide important information to guide future system‐wide implementation efforts. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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