Background: Accurate reporting of interventions is crucial for replicating results and supporting uptake into clinical practice. Reporting guidelines have facilitated the development of promising protocolised non-pharmacological interventions for chronic pain. Despite this, no literature explores their adaptation by health professionals into clinical practice. Current guidelines recommend a mixed-method approach to investigate protocolised interventions. This study explored how health professionals adapt protocolised interventions from the literature into practice, using Graded Motor Imagery (GMI) for treating Phantom Limb Pain (PLP) as an example.
Methods: A qualitative study design was underpinned by interpretivism epistemology and used a relativist ontological perspective. Health professionals who treated at least one PLP patient in the last 12 months were recruited to participate in an online questionnaire and individual semi-structured interviews. The sample size was determined using saturation. Audio data was transcribed and analysed using reflexive thematic analysis.
Results: We interviewed 21 participants, identifying six themes that captured their experiences: (1) Intervention Effectiveness: Participants valued the effectiveness of protocolised interventions for managing chronic pain. (2) Flexible Treatment Programs: There was a strong preference for flexible treatment programs over rigid protocols. (3) Understanding the Theory: Participants did not fully understand the theory behind chronic pain interventions and agreed on the need for better training. (4) Targeting Condition-Specific Considerations: Protocolised interventions like GMI helped individuals manage grief and the emotional aspects of limb loss. (5) Clinical Challenges: Participants reported limited resources, difficulties in accepting the concepts, and varying access to care. (6) Effective Delivery Strategies: Successful delivery of protocolised interventions requires multidisciplinary teamwork, clear treatment expectations, and integrating technologies.
Conclusion: The adaptation of protocolised interventions like GMI from research literature into clinical practice requires significant modifications driven by practical and patient-specific considerations. Designing interventions through co-production with patients and clinicians, considering their perspectives and feasibility, and developing flexible treatment protocols are essential. Addressing identified barriers and enhancing facilitators will improve the effective implementation of these interventions for chronic pain conditions.