Leveraging a Qualitative Evaluation of a Telehealth Pain Management Program

Research Objectives: In response to the Veteran pain crisis and the national opioid epidemic, the TelePain-Empower Veterans Program (EVP) was developed as a non-pharmacological intervention to help Veterans manage chronic pain. This evaluation aimed to identify determinants of program implementation, user experiences, and benefits and challenges to participation.

Design: Qualitative descriptive evaluation using semi-structured telephone interviews, as part of a larger mixed-methods prospective study.

Setting: A Veterans Health Administration facility in southeastern United States.

Participants: Data were collected with program leaders (n=3), staff (n=10), and Veteran participants (n=15).

Interventions: TelePain-EVP is a 10-week synchronous virtual pain management training program incorporating complementary integrated health, acceptance and commitment therapy, and mindful movement.

Main Outcome Measures: Interview questions aligned with the Consolidated Framework for Implementation Research (CFIR). Rapid analysis was used to generate themes for actionable feedback to inform implementation.

Results: CFIR domains and constructs emerged as relevant to program implementation, including innovation, inner and outer settings, individuals, and implementation processes. Identified determinants informed factors which were facilitators and barriers to implementation. Clinical care and administrative respondents reported on factors relevant to intervention characteristics, technology factors, team dynamics and organizational and structural characteristics, which impact implementation. Analysis of Veteran reports gleaned data about intervention experience, outcomes, and recommendations for improving the intervention from a patient-centered perspective.

Conclusions: Remotely delivered pain management programs provide a nonpharmacological approach while improving access to care and benefitting participants with chronic pain. Data findings warrant electronic data collection for TelePain-EVP to improve accountability and real-time outcomes assessment. Data warrant consideration for using centralized staff and data management networks to address Staffing needs, training, and data management.

Author(s) Disclosures:

Funding: Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health (PEC-21-129) and Pain Management, Opioid Safety and Prescription Drug Monitoring Program (SP8E-PMTIA160)