Overcoming Barriers to the Implementation of Integrated Musculoskeletal Pain Management Programs: A Multi-Stakeholder...

Area of Science:

• Pain Management
• Health Services Research
• Qualitative Health Research

Background:

• Musculoskeletal pain presents a significant public health challenge.
• Integrated Pain Management (IPM) programs offer a solution but face implementation barriers.
• Existing IPM programs provide valuable lessons for wider adoption.

Purpose of the Study:

• To identify and analyze barriers and facilitators to developing and sustaining IPM programs.
• To describe strategies used by stakeholders to overcome implementation challenges.
• To inform the expansion of IPM program delivery across diverse settings.

Main Methods:

• Qualitative study utilizing a multi-sector expert panel (25 stakeholders).
• Data collection included 53 expert interviews and 4 case studies of IPM programs in the US (Feb 2020-Sep 2021).
• Consensual team-based analysis of qualitative findings.

Main Results:

• Four key themes emerged: navigating payment/reimbursement, organizational change, business case development, and regulatory hurdles.
• Strategies included value-based payments, clinical champions, co-location, demonstrating cost reduction, and innovative credentialing.
• Successful approaches address financial, operational, and regulatory complexities.

Conclusions:

• Actionable strategies exist to overcome IPM implementation challenges.
• Health systems, providers, and payers can leverage these lessons to expand IPM.
• Improving access to IPM can reduce the burden of musculoskeletal pain.