The Perpetual Evidence-Practice Gap: Addressing Ongoing Barriers to Chronic Pain Management in Primary Care in Three Steps

Authors

Laura Ellen Ashcraft
Megan E Hamm
Serwaa S Omowale
Valerie Hruschak
Elizabeth Miller
Shaun M Eack
Jessica S Merlin

Language

English

Publication Date

1-1-2024

Journal

Frontiers in Pain Reserach

DOI

10.3389/fpain.2024.1376462

PMID

39439739

PMCID

PMC11493740

PubMedCentral® Posted Date

10-8-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Most management of chronic pain, a serious illness affecting the physical and psychological wellbeing of millions, occurs in primary care settings. Primary care practitioners (PCPs) attempt to provide evidence-based practices to treat chronic pain. However, there continues to be a gap between the care people receive and the evidence. The objectives for this study were to (1) explore determinants of evidence-based chronic pain management and (2) develop a novel approach to using implementation science to address the evidence-practice gap.

Method: A convenience sample of twenty-one Pennsylvania PCPs participated in one-time semi-structured telephone interviews. Interviews were transcribed verbatim and both deductive and inductive approaches were used during analysis. We used the Consolidated Framework for Implementation Research (CFIR) and the Expert Recommendations for Implementing Change (ERIC) to inform our analysis and findings.

Results: We identified determinants of evidence-based chronic pain management across the CFIR domains of Intervention Characteristics, Characteristics of Individuals, and the Outer Setting and reported implementation strategies. Based on identified themes, we developed a three-step process to support the ongoing and pragmatic implementation of evidence-based chronic pain management in primary care settings.

Conclusions: Previous efforts exist to integrate implementation science into chronic pain management; yet a gap persists. Implementation approaches should prioritize the needs of people living with chronic pain and their families. Further, future approaches or strategies used should build on the current three-step model to include the fourth step of tailoring existing implementation strategies to the specific needs of chronic pain in the clinical context.

Keywords

primary care, chronic pain, implementation science, qualitative research, methods

Published Open-Access

yes

Recommended Citation

Ashcraft, Laura Ellen; Hamm, Megan E; Omowale, Serwaa S; et al., "The Perpetual Evidence-Practice Gap: Addressing Ongoing Barriers to Chronic Pain Management in Primary Care in Three Steps" (2024). Faculty, Staff and Student Publications. 1102.
https://digitalcommons.library.tmc.edu/uthsph_docs/1102