Faculty of Psychology, University of Málaga, Málaga, Spain.
Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain.
Eur J Pain. 2024 Sep;28(8):1257-1275. doi: 10.1002/ejp.2262. Epub 2024 Mar 14.
BACKGROUND AND OBJECTIVE: The development, evaluation and implementation of digital self-management interventions for chronic pain have increased exponentially. While intervention outcomes appear promising to improve well-being and functioning in target populations, it is unclear how the development and evaluation processes were structured and how implementation was planned and executed. The aim of this systematic review is to provide a comprehensive overview of implementation frameworks used to guide and evaluate scientific innovation in chronic pain. DATABASES AND DATA TREATMENT: Four bibliography databases (Medline, Web of Science, PsycInfo, CINAHL) and two registries (PubMed Central, MedaRxiv) were systematically searched. Hits (n = 6830) and full texts (n = 351) were screened and read by two independent reviewers. Peer-reviewed articles that met the inclusion criteria were included in the narrative synthesis. RESULTS: In total, 10 studies were identified that report on seven distinct interventions. Five implementation frameworks were utilized across these studies: Behavioural Interventions using Technology (BIT); Consolidated Framework for Implementation Research (CFIR); mHealth Agile and User-Centered Research and Development Lifecycle; Medical Research Council (MRC); Reach, Effectiveness, Adoption Implementation, and Maintenance (RE-AIM). Frameworks were operationalized using qualitative and quantitative methods, evaluating the innovation on various levels (e.g., individual vs. organizational) and applying a variety of study designs (e.g., single-arm or large trials). CONCLUSIONS: By utilizing implementation frameworks, access to evidence-based chronic pain care may be increased. Although the evidence on the utility of implementation frameworks to guide and evaluate digital self-management interventions is still limited, the body of literature is increasing. Future studies are urged to operationalize, communicate and discuss the innovation process, to promote transparency and replicability. SIGNIFICANCE: The use of implementation frameworks to guide and evaluate digital self-management interventions for chronic pain is a recent development in the field. Several promising examples exist and are presented in this review. Currently, the evidence is still limited, and prospective studies need to transparently operationalize, communicate and discuss their efforts. By utilizing an implementation framework, promising interventions can be made available to end-users, closing the research-to-clinical practice gap and increasing access to evidence-based care to people with chronic pain.
背景和目的:数字自我管理干预慢性疼痛的开发、评估和实施呈指数级增长。虽然干预结果似乎有望改善目标人群的幸福感和功能,但尚不清楚开发和评估过程是如何构建的,以及实施是如何计划和执行的。本系统评价的目的是提供一个全面的概述,用于指导和评估慢性疼痛科学创新的实施框架。
数据库和数据处理:系统地搜索了四个书目数据库(Medline、Web of Science、PsycInfo、CINAHL)和两个注册处(PubMed Central、MedaRxiv)。两名独立评审员筛选并阅读了命中(n=6830)和全文(n=351)。符合纳入标准的同行评议文章被纳入叙述性综合分析。
结果:总共确定了 10 项研究,这些研究报告了 7 种不同的干预措施。这 10 项研究中有 5 个实施框架被利用:使用技术的行为干预(BIT);实施研究综合框架(CFIR);移动健康敏捷和用户为中心的研究和开发生命周期;医学研究委员会(MRC);到达、有效性、采用、实施和维持(RE-AIM)。框架通过定性和定量方法进行操作,在不同层面(例如,个体与组织)评估创新,并采用各种研究设计(例如,单臂或大型试验)。
结论:通过利用实施框架,可以增加获得循证慢性疼痛治疗的机会。尽管利用实施框架来指导和评估数字自我管理干预慢性疼痛的证据仍然有限,但文献数量正在增加。敦促未来的研究对创新过程进行操作化、沟通和讨论,以提高透明度和可复制性。
意义:在慢性疼痛领域,使用实施框架来指导和评估数字自我管理干预措施是一个新的发展。本综述介绍了一些有前途的例子。目前,证据仍然有限,需要前瞻性研究透明地操作、沟通和讨论他们的努力。通过利用实施框架,可以将有前途的干预措施提供给最终用户,缩小研究与临床实践之间的差距,并增加慢性疼痛患者获得循证治疗的机会。
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