Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathway
Abstract Background Approximately 20% of people who have total knee replacement experience chronic pain afterwards, but there is little evidence about effective interventions for managing this type of pain. This article describes the systematic development and refinement of a complex intervention fo...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | Trials |
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| Online Access: | http://link.springer.com/article/10.1186/s13063-017-2391-8 |
| _version_ | 1811274166517628928 |
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| author | Vikki Wylde Nicholas Howells Wendy Bertram Andrew J. Moore Julie Bruce Candy McCabe Ashley W. Blom Jane Dennis Amanda Burston Rachael Gooberman-Hill |
| author_facet | Vikki Wylde Nicholas Howells Wendy Bertram Andrew J. Moore Julie Bruce Candy McCabe Ashley W. Blom Jane Dennis Amanda Burston Rachael Gooberman-Hill |
| author_sort | Vikki Wylde |
| collection | DOAJ |
| description | Abstract Background Approximately 20% of people who have total knee replacement experience chronic pain afterwards, but there is little evidence about effective interventions for managing this type of pain. This article describes the systematic development and refinement of a complex intervention for people with chronic pain after knee replacement. The intervention is a care pathway involving an assessment clinic and onward referral, with telephone follow-up as required. In the design of this multistage study, we chose to focus on ensuring that the intervention was deliverable, implementable and acceptable. Methods In line with the UK Medical Research Council’s recommendations for comprehensive development of complex interventions, multiple phases of work were undertaken. Following on from initial development work to design the intervention, the draft intervention content was refined through consensus questionnaires with 22 health professionals and discussion at meetings with 18 healthcare professionals. Testing of intervention delivery and acceptability to patients was undertaken by two health professionals delivering the assessment clinic to ten patients. Views about future implementation within the context of a randomised trial were evaluated through a questionnaire based on the Normalisation Measure Development (NoMAD) instrument with ten health professional stakeholders. Results Consensus work with health professionals ensured the components of the intervention were appropriate and informed a number of substantive changes to improve the intervention. Testing of intervention delivery identified a number of logistical issues that were then addressed in the development of a comprehensive intervention training manual. Engagement with stakeholders indicated that the intervention could be successfully implemented in a clinical setting for evaluation in a randomised trial. Conclusions This work has informed the development and refinement of a complex intervention for people with chronic pain after knee replacement. The next stage is to evaluate the clinical and cost-effectiveness of the STAR care pathway in a multicentre randomised trial. |
| first_indexed | 2024-04-12T23:14:06Z |
| format | Article |
| id | doaj.art-8fc4fcd00709455c9c88e42746f235aa |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-04-12T23:14:06Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-8fc4fcd00709455c9c88e42746f235aa2022-12-22T03:12:44ZengBMCTrials1745-62152018-01-011911910.1186/s13063-017-2391-8Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathwayVikki Wylde0Nicholas Howells1Wendy Bertram2Andrew J. Moore3Julie Bruce4Candy McCabe5Ashley W. Blom6Jane Dennis7Amanda Burston8Rachael Gooberman-Hill9Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Southmead HospitalNorth Bristol NHS Trust, Brunel Building, Southmead HospitalMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Southmead HospitalMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Southmead HospitalWarwick Clinical Trials Unit, Warwick Medical School, University of WarwickDepartment of Nursing and Midwifery, Faculty of Health and Applied Sciences, University of the West of EnglandMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Southmead HospitalMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Southmead HospitalMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Southmead HospitalMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building, Southmead HospitalAbstract Background Approximately 20% of people who have total knee replacement experience chronic pain afterwards, but there is little evidence about effective interventions for managing this type of pain. This article describes the systematic development and refinement of a complex intervention for people with chronic pain after knee replacement. The intervention is a care pathway involving an assessment clinic and onward referral, with telephone follow-up as required. In the design of this multistage study, we chose to focus on ensuring that the intervention was deliverable, implementable and acceptable. Methods In line with the UK Medical Research Council’s recommendations for comprehensive development of complex interventions, multiple phases of work were undertaken. Following on from initial development work to design the intervention, the draft intervention content was refined through consensus questionnaires with 22 health professionals and discussion at meetings with 18 healthcare professionals. Testing of intervention delivery and acceptability to patients was undertaken by two health professionals delivering the assessment clinic to ten patients. Views about future implementation within the context of a randomised trial were evaluated through a questionnaire based on the Normalisation Measure Development (NoMAD) instrument with ten health professional stakeholders. Results Consensus work with health professionals ensured the components of the intervention were appropriate and informed a number of substantive changes to improve the intervention. Testing of intervention delivery identified a number of logistical issues that were then addressed in the development of a comprehensive intervention training manual. Engagement with stakeholders indicated that the intervention could be successfully implemented in a clinical setting for evaluation in a randomised trial. Conclusions This work has informed the development and refinement of a complex intervention for people with chronic pain after knee replacement. The next stage is to evaluate the clinical and cost-effectiveness of the STAR care pathway in a multicentre randomised trial.http://link.springer.com/article/10.1186/s13063-017-2391-8Total knee replacementChronic painComplex intervention development |
| spellingShingle | Vikki Wylde Nicholas Howells Wendy Bertram Andrew J. Moore Julie Bruce Candy McCabe Ashley W. Blom Jane Dennis Amanda Burston Rachael Gooberman-Hill Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathway Trials Total knee replacement Chronic pain Complex intervention development |
| title | Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathway |
| title_full | Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathway |
| title_fullStr | Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathway |
| title_full_unstemmed | Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathway |
| title_short | Development of a complex intervention for people with chronic pain after knee replacement: the STAR care pathway |
| title_sort | development of a complex intervention for people with chronic pain after knee replacement the star care pathway |
| topic | Total knee replacement Chronic pain Complex intervention development |
| url | http://link.springer.com/article/10.1186/s13063-017-2391-8 |
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