Improving Physical Therapy Pain Care, Quality, and Cost Through Effectiveness-Implementation Research

The variability and delay in utilizing evidence in clinical practice are barriers to improving care, quality, and cost in health care, as charged by the "triple aim" framework. Scientific research provides an avenue not only to further the field of pain research, but also to study and change the patterns and processes that drive systemic and individual clinical practices. Implementation science is an emerging field that can be integrated with more traditional effectiveness research to accomplish a combination of aims within the same study. This type of concurrent study of effectiveness and implementation is known as a hybrid design and can be used to improve behavioral or operational practice patterns as well as to collect evidence of clinical effectiveness. Recently, the National Pain Strategy put forth recommendations to improve the care of patients with pain through research and practice. Hybrid designs align well with recent efforts that emphasize value-based, patient-centered health care evolving and described in the National Pain Strategy. The purposes of this perspective are to describe implementation science and hybrid studies and to put forth opportunities to utilize this research to advance the care of patients with pain in the United States.