Implementation frameworks guiding digital self-management intervention in chronic pain: A scoping review
R de la Vega1,2, S L Bartels3,4, R W Wicksell3,5
1Faculty of Psychology, University of Málaga, Málaga, Spain.
European Journal of Pain (London, England)
|March 14, 2024
Summary
Digital self-management interventions for chronic pain show promise. This review examines implementation frameworks used to guide and evaluate these innovations, aiming to improve access to evidence-based care.
Area of Science:
- Digital health interventions
- Chronic pain management
- Implementation science
Background:
- Digital self-management interventions for chronic pain are rapidly developing.
- While promising, their development, evaluation, and implementation processes are not well-understood.
- Understanding these processes is crucial for effective translation into practice.
Purpose of the Study:
- To systematically review and provide a comprehensive overview of implementation frameworks.
- To identify frameworks used to guide and evaluate scientific innovation in chronic pain digital interventions.
- To assess how these frameworks structure development, evaluation, and implementation.
Main Methods:
- Systematic search of four bibliographic databases (Medline, Web of Science, PsycInfo, CINAHL) and two registries (PubMed Central, MedaRxiv).
- Screening of 6830 hits and full-text review of 351 articles by two independent reviewers.
- Narrative synthesis of 10 peer-reviewed articles meeting inclusion criteria.
Main Results:
- Ten studies reporting on seven distinct digital interventions were identified.
- Five implementation frameworks were utilized: Behavioural Interventions using Technology (BIT), Consolidated Framework for Implementation Research (CFIR), mHealth Agile and User-Centered Research and Development Lifecycle, Medical Research Council (MRC), and Reach, Effectiveness, Adoption Implementation, and Maintenance (RE-AIM).
- Frameworks were operationalized using mixed methods, evaluating interventions at individual and organizational levels across various study designs.
Conclusions:
- Implementation frameworks can potentially increase access to evidence-based chronic pain care.
- The evidence on the utility of these frameworks for digital self-management interventions is still emerging but growing.
- Future research should transparently operationalize, communicate, and discuss innovation processes to enhance replicability and impact.
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