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. 2022 Sep 15;17(9):e0273030.
doi: 10.1371/journal.pone.0273030. eCollection 2022.

Exploring the feasibility of a network of organizations for pain rehabilitation: What are the lessons learned?

Cynthia Lamper  1 , Ivan P J Huijnen  1   2 , Mariëlle E A L Kroese  3 , Albère J Köke  1   2 , Gijs Brouwer  3 , Dirk Ruwaard  3 , Jeanine A M C F Verbunt  1   2
Affiliations

Exploring the feasibility of a network of organizations for pain rehabilitation: What are the lessons learned?

Cynthia Lamper et al. PLoS One. .

Abstract

Background and aims: Integration of care is lacking for chronic musculoskeletal pain patients. Network Pain Rehabilitation Limburg, a transmural health care network, has been designed to provide integrated rehabilitation care from a biopsychosocial perspective to improve patients' levels of functioning. This feasibility study aims to provide insight into barriers and facilitators for the development, implementation, and transferability.

Methods: This study was conducted with a three-phase iterative and incremental design from October 2017 to October 2018. The network comprises two rehabilitation practices, and three local primary care networks, with a general practitioner together with, a mental health practice nurse, and a physiotherapist or exercise therapist. These stakeholders with a random sample of participating patients took part in evaluations, consisting of interviews, focus groups, and observations. Field notes and observations were recorded during meetings. The Consolidated Framework for Implementation Research guided data collection and analysis. Results were used to refine the next phase.

Results: According to health care professionals, guidelines and treatment protocols facilitate consistency and transparency in collaboration, biopsychosocial language, and treatment. One mentioned barrier is the stigmatization of chronic pain by the general population. In regular care, approaches are often more biomedical than biopsychosocial, causing patients to resist participating. The current organization of health care acts as a barrier, complicating implementation between and within practices. Health care professionals were enthusiastic about the iterative, bottom-up development. A critical mass of participating organizations is needed for proper implementation.

Conclusion: Network Pain Rehabilitation Limburg is feasible in daily practice if barriers are overcome and facilitators of development, implementation, and transferability are promoted. These findings will be used to refine Network Pain Rehabilitation Limburg. A large-scale process and effect evaluation will be performed. Our implementation strategies and results may assist other health care organizations aspiring to implement a transmural network using a similar model.

Trail registration: Registration number: NTR6654 or https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6654.

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Conflict of interest statement

IH, AK, and JV report grants from Health Insurance Companies CZ, VGZ and Achmea, during the conduct of the study. The other authors declare that there is no conflict of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Consolidated framework for integrated care adjusted for Network Pain Rehabilitation Limburg.
See this image and copyright information in PMC

References

    1. Bekkering GE, Bala MM, Reid K, Kellen E, Harker J, Riemsma R, et al. Epidemiology of chronic pain and its treatment in The Netherlands. Neth J Med. 2011;69(3):141–53. . - PubMed
    1. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133(4):581–624. doi: 10.1037/0033-2909.133.4.581 . - DOI - PubMed
    1. Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci. 2013;14(7):502–11. doi: 10.1038/nrn3516 . - DOI - PMC - PubMed
    1. Breivik H, Eisenberg E, O’Brien T, Openminds. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health. 2013;13:1229. doi: 10.1186/1471-2458-13-1229 . - DOI - PMC - PubMed
    1. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287–333. doi: 10.1016/j.ejpain.2005.06.009 . - DOI - PubMed

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