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. 2023 Apr 10;24(1):277.
doi: 10.1186/s12891-023-06360-7.

Implementation of an online pain science education for chronic musculoskeletal pain in Brazilian public health system: protocol for a hybrid type III randomised controlled trial with economic evaluation

Marina P Baroni  1   2   3 , Luiz Hespanhol  4   5 , Gisela C Miyamoto  4   6 , Christiane R Daniel  7   8 , Lívia G Fernandes  4   9 , Felipe J J Dos Reis  10 , Joshua W Pate  11 , Bruno T Saragiotto  4   9   11
Affiliations

Implementation of an online pain science education for chronic musculoskeletal pain in Brazilian public health system: protocol for a hybrid type III randomised controlled trial with economic evaluation

Marina P Baroni et al. BMC Musculoskelet Disord. .

Abstract

Background: Although clinical practice guidelines recommend pain education as the first-line option for the management of chronic musculoskeletal pain, there is a lack of pain education programmes in healthcare. Thus, digital health programmes can be an effective tool for implementing pain education strategies for public health. This trial will aim to analyse the implementation and effectiveness outcomes of three online pain science education strategies in the Brazilian public health system (SUS) for individuals with chronic musculoskeletal pain.

Methods: We will conduct a hybrid type III effectiveness-implementation randomised controlled trial with economic evaluation. We will include adult individuals with chronic musculoskeletal pain, recruited from primary healthcare in the city of Guarapuava, Brazil. Individuals will be randomised to three implementation groups receiving a pain science education intervention (EducaDor) but delivered in different modalities: group 1) synchronous online; group 2) asynchronous videos; and group 3) interactive e-book only. Implementation outcomes will include acceptability, appropriateness, feasibility, adoption, fidelity, penetration, sustainability, and costs. We will also assess effectiveness outcomes, such as pain, function, quality of life, sleep, self-efficacy, and adverse effects. Cost-effectiveness and cost-utility analyses will be conducted from the SUS and societal perspectives. The evaluations will be done at baseline, post-intervention (10 weeks), and 6 months.

Discussion: This study will develop and implement a collaborative intervention model involving primary healthcare professionals, secondary-level healthcare providers, and patients to enhance self-management of chronic pain. In addition to promoting better pain management, this study will also contribute to the field of implementation science in public health by generating important insights and recommendations for future interventions.

Trial registration: ClinicalTrials.gov (NCT05302180; 03/29/2022).

Keywords: Chronic pain; Health education; Implementation science; Primary healthcare; Public health; Telehealth.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
SPIRIT recommended content for the schedule of enrollment, interventions and assessments. Figure legend: wk: week; mo: month
Fig. 2
Fig. 2
Schematic representation for the referral of SUS users with chronic musculoskeletal pain to Educador programme
Fig. 3
Fig. 3
Adaptation of Proctor’s conceptual model of implementation research
See this image and copyright information in PMC

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References

    1. Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the iasp classification of chronic pain for the International Classification of Diseases (ICD-11) Pain. 2019;160(1):19–27. doi: 10.1097/j.pain.0000000000001384. - DOI - PubMed
    1. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021;396(10267):2006–2017. doi: 10.1016/S0140-6736(20)32340-0. - DOI - PMC - PubMed
    1. Elzahaf RA, Tashani OA, Unsworth BA, Johnson MI. The prevalence of chronic pain with an analysis of countries with a Human Development Index less than 0.9: a systematic review without meta-analysis. Curr Med Res Opin. 2012;28(7):1221–9. doi: 10.1185/03007995.2012.703132. - DOI - PubMed
    1. Qaseem A, Wilt TJ, McLean RM, Forciea MA, Clinical Guidelines Committee of the American College of Physicians. Denberg TD, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):515–30. doi: 10.7326/M16-2367. - DOI - PubMed
    1. Mills S, Torrance N, Smith BH. Identification and management of chronic pain in primary care: a review. Curr Psychiatry Rep. 2016;18(2):18–22. doi: 10.1007/s11920-015-0659-9. - DOI - PMC - PubMed

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