Hurdles and potentials when implementing internet-delivered acceptance and commitment therapy in interdisciplinary pain rehabilitation programs: A retrospective appraisal using the quality implementation framework

Presentatörer: Nina Bendelin, PhD ¹, Björn Gerdle, PhD Prof ¹, Gerhard Andersson PhD Prof ^2,3,4.

¹Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, ²Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden, ³Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden, ⁴Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden

Bakgrund: Internet-delivered psychological interventions can be regarded as evidence-based practices and have been implemented in psychiatric and somatic care at primary and specialist levels. Specifically, internet-delivered Acceptance and Commitment Therapy (IACT), has been found helpful for chronic pain patients and might aid in developing pain rehabilitation services. However, the integration of IACT into regular health care has not yet been described from an implementation science perspective.

Syfte: The aim of this hybrid 1 effectiveness-implementation study was to evaluate the process of implementing IACT in a pain rehabilitation setting, to guide future implementation initiatives.

Metod: In this retrospective study, we described actions taken during an implementation initiative, in which IACT was delivered as part of an interdisciplinary pain rehabilitation program (IPRP) at a specialist clinic. All documents relevant for the study were reviewed and coded using the Quality Implementation Framework (QIF).

Resultat: The QIF-analysis of implementation actions resulted in two categories: Facilitators and Challenges for implementation. Buy-in from leadership, infrastructure for multidisciplinary communication and dedicated key champion team members facilitated implementation. However, insufficient contextual considerations and structure challenged assessment and capacity-building and caused difficulties to adapt to hurdles. Possible influential factors, hypotheses and key process challenges are presented in a logic model to guide future initiatives and move implementation of IACT in IPRPs forward.

Slutsats: Sustainable implementation may depend on both the continuity of facilitating implementation actions and flexibility to the dynamic and changing needs and interests among end-users, providers and stakeholders. We recommend the use of logic models to ease implementation of IACT into IPRP.