Hurdles and potentials when implementing internet-delivered Acceptance and commitment therapy for chronic pain: a...

Area of Science:

• Implementation science
• Digital health interventions
• Chronic pain management

Background:

• Internet-delivered psychological interventions are evidence-based but face adherence and routinization challenges in chronic pain care.
• Internet-delivered Acceptance and Commitment Therapy (IACT) shows promise for chronic pain patients and rehabilitation services.
• Integration of IACT into standard healthcare lacks description from an implementation science perspective.

Purpose of the Study:

• To evaluate the process of implementing IACT in a pain rehabilitation setting.
• To guide future implementation initiatives for IACT in chronic pain care.
• To analyze facilitators and challenges using the Quality Improvement Framework (QIF).

Main Methods:

• Retrospective review of actions during an IACT implementation initiative within an interdisciplinary pain rehabilitation program (IPRP).
• Coding of relevant documents using the Quality Improvement Framework (QIF) to assess adoption, appropriateness, and sustainability.
• Development of a logic model to present influential factors, hypotheses, and key process challenges.

Main Results:

• Sustainability is facilitated by adapting to clinical needs and challenged by capacity building issues.
• Appropriateness is enhanced by aligning communication with existing infrastructure but challenged by insufficient needs assessment.
• Adoption is supported by staff champions and adaptability, with key process challenges identified.

Conclusions:

• Sustainable implementation requires continuity of facilitating actions and flexibility towards stakeholder needs.
• The use of theories, models, and frameworks (TMF), along with a logic model, aids implementation planning and evaluation.
• IACT may be suitable for IPRP, particularly for addressing psychiatric comorbidities when delivered before or after the program.