Poster Presentation Sydney Spinal Symposium 2025

Bridging the gap from evidence to practice: adaptation and implementation of a novel treatment for people with chronic low back pain.  (#4)

Martjie Venter 1 2 , Michael Hodgins 3 , Benedict M Wand 4 , Matthew K Bagg 2 4 , Brendan Mouatt 5 6 , Hayley B Leake 5 , Rodrigo NR Rizzo 1 2 , Steven Marsh 2 , Felicity Braithwaite 5 6 , Tasha R Stanton 5 6 , G Lorimer Moseley 5 , James H McAuley 1 2 , Aidan G Cashin 1 2
  1. School of Health Sciences , University of New South Wales , Sydney , NSW, Australia
  2. Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, NSW, Australia
  3. School of Clinical Medicine, University of New South Wales , Sydney , NSW, Australia
  4. School of Health Sciences, The University of Notre Dame Australia, Fremantle, WA, Australia
  5. IIMPACT (Innovation, IMPlementation And Clinical Translation) in Health, University of South Australia, Adelaide, SA, Australia
  6. Persistent Pain Research Group, Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australia Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia

Objectives and Background:

Improved understanding of the mechanisms that generate and maintain chronic pain has provided opportunities to develop new treatment programs. The RESOLVE trial investigated whether a new multi-stage rehabilitation program based on this new understanding of chronic pain, graded sensorimotor retraining (RESOLVE intervention), improved pain intensity and disability in people with chronic low back pain compared to a sham control group. The trial showed meaningful and sustained benefits up to one year. Although promising, the treatment needs to be adapted and tested in a more pragmatic setting before implementation in clinical practice. This study aims to 1) identify the core and adaptable components of the RESOLVE intervention, and 2) to co-adapt the RESOLVE intervention package for clinical practice.

 

Methods:

This was a two-stage study using a mixed methods approach. The stages were 1) evidence review and stakeholder engagement, and 2) co-adaptation of the RESOLVE intervention package. Stage one involved secondary analyses of the RESOLVE trial investigating treatment mechanisms and effect modifiers; and conducting qualitative interviews to investigate the perspectives of key stakeholders (n=18) on implementation. Stage two involved co-adaptation activities based on stage one findings, with a team of expert representatives. Our methodology is informed by the ADAPT guidance and co-production frameworks by Hawkins and Madden (2017).

 

Results: Adaptations were made to four areas of the intervention. These included: enabling flexible progression through the program, improving program structure flexibility, updating educational content and resources, and improving practical elements of the intervention.

 

Conclusion: This study outlines how the RESOLVE intervention was co-adapted for use in clinical practice. The approach could be used as a framework to guide the adaptation of other complex interventions for chronic pain. The adapted RESOLVE intervention will be further investigated in an effectiveness-implementation trial in primary care.