Intervention delivery complexity and adaptations for implementation of non-pharmacologic pain interventions

Area of Science:

• Clinical Research
• Implementation Science
• Pain Management

Background:

• Delivering evidence-based interventions for chronic musculoskeletal pain is challenging due to complexity and resource demands.
• Non-pharmacologic treatments are recommended but difficult to implement.
• Pragmatic trials, particularly embedded designs, assess real-world intervention implementation and adaptation.

Purpose of the Study:

• To explore differences in intervention delivery complexity and adaptations between non-pharmacologic pain trials and non-pain trials.
• To provide guidance for future treatment delivery and implementation strategies.
• To understand challenges in implementing complex interventions in real-world settings.

Main Methods:

• An online survey assessed intervention delivery complexity and adaptations in pragmatic trials.
• Participants rated complexity using a 7-item tool and reported adaptations.
• Data compared complexity and adaptations between pain and non-pain trials.

Main Results:

• Intervention delivery complexity was not discernibly different between pain and non-pain trials, though pain trials had slightly higher overall complexity.
• Pain trials reported more adaptations in the workflow domain compared to non-pain trials.
• Workflow was the most challenging domain for adaptation across all trials.

Conclusions:

• Pragmatic trials investigating non-pharmacologic pain interventions may have slightly higher intervention delivery complexity in specific areas compared to non-pain trials.
• Workflow adaptations are a key area of difference and challenge in pain-focused pragmatic trials.
• Findings offer insights into optimizing the implementation of complex, non-pharmacologic pain interventions.