Zhao Emma, Vaccaro Lisa, Lee Yi-Ching, Brake Timothy James, Serafimovska Anastasia
Pain Management Centre, Royal Prince Alfred Hospital, Camperdown, Australia.
Pain Medicine Research, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
JMIR Res Protoc. 2025 Jun 18;14:e59126. doi: 10.2196/59126.
Current gold standard chronic pain management applies a biopsychosocial lens to clinical care, integrating medication, psychosocial support, and physical reconditioning to promote sustained treatment success, increase quality of life, and control symptoms. However, only 40% of patients with chronic pain report adequate pain management. Unfortunately, evidence describing implemented treatment pathways or models of care (MoCs) that consistently use this holistic approach is lacking.
The aim of this study is to identify the barriers and facilitators to access and engagement in existing MoCs for chronic pain, explore aspects of the delivery of care that can be improved, and develop an improved MoC for pain clinics in New South Wales by directly liaising with people with chronic pain and their families.
A 2-phase qualitative study will be conducted using semistructured focus groups. Both phases will follow the same structure, so patients, carers, and clinicians will independently provide input into the proposed MoC, which will then be summarized and integrated by the research team. Participants will be encouraged to interact and speak freely across three core domains: (1) experience of chronic pain management, (2) barriers and facilitators to delivering/accessing a gold standard MoC, and (3) key improvement points to existing models. Each focus group will last 90 minutes and be audio-recorded and transcribed verbatim for qualitative analysis. The focus groups in phase one will generate initial recommendations for primary changes to the existing MoC, and these will then be integrated and presented for evaluation, feasibility, and acceptability by stakeholder groups during phase two.
Data collection commenced in September 2023 and is expected to end by September 2025. As of February 2024, we have completed the focus group with clinicians (n=12) and patients (n=7) in phase one. Data have not been analyzed formally and will be reported in a future publication.
Through the exploration of key stakeholders' perspectives of the barriers preventing access and the delivery of care in the current MoC for chronic pain, we aim to co-design an appropriate, feasible, and acceptable pathway to be implemented in pain services in the future.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/59126.
当前慢性疼痛管理的金标准是在临床护理中采用生物心理社会视角，整合药物治疗、心理社会支持和身体康复，以促进持续的治疗成功、提高生活质量并控制症状。然而，只有40%的慢性疼痛患者报告疼痛得到了充分管理。不幸的是，缺乏描述始终采用这种整体方法的已实施治疗途径或护理模式（MoC）的证据。
本研究的目的是确定现有慢性疼痛MoC中获取和参与的障碍及促进因素，探索可改进的护理提供方面，并通过直接与慢性疼痛患者及其家人联系，为新南威尔士州的疼痛诊所开发一种改进的MoC。
将使用半结构化焦点小组进行一项两阶段定性研究。两个阶段将遵循相同的结构，因此患者、护理人员和临床医生将独立为拟议的MoC提供意见，然后由研究团队进行总结和整合。将鼓励参与者在三个核心领域进行互动并自由发言：（1）慢性疼痛管理经验，（2）提供/获取金标准MoC的障碍及促进因素，以及（3）现有模式的关键改进点。每个焦点小组将持续90分钟，并进行录音和逐字转录以进行定性分析。第一阶段的焦点小组将为现有MoC的主要变更提出初步建议，然后在第二阶段由利益相关者群体对这些建议进行整合并评估其可行性和可接受性。
数据收集于2023年9月开始，预计于202五年9月结束。截至2024年2月，我们已在第一阶段完成了与临床医生（n = 12）和患者（n = 7）的焦点小组。数据尚未进行正式分析，将在未来的出版物中报告。
通过探索关键利益相关者对当前慢性疼痛MoC中阻碍获取和提供护理的障碍的看法，我们旨在共同设计一条合适、可行且可接受的途径，以便将来在疼痛服务中实施。
国际注册报告标识符（IRRID）：DERR1-10.2196/59126。
