Developing the Network Pain Rehabilitation Limburg: a feasibility study protocol

BMJ Open. 2019 Jun 27;9(6):e025962. doi: 10.1136/bmjopen-2018-025962.


Introduction: Patients having chronic musculoskeletal pain (CMP) face challenges as mismatches often exist between the complexity of patient's pain problem and the rehabilitation treatment offered. This can result in less efficient care for the patient and increased medical shopping. The Network Pain Rehabilitation Limburg (NPRL), a transmural integrated healthcare network, will be designed to improve daily care for patients with CMP. NPRL focusses on improving patient's level of functioning despite pain by stimulating a biopsychosocial approach given by all involved healthcare professionals. A feasibility study will be performed which will give insight into the barriers and facilitators, perceived value, acceptability and implementation strategies for NPRL.

Methods and analysis: This study has a three-phase iterative and incremental design, based on key principles of a user-centred design. Mixed methods will be used in which healthcare professionals and patients involved in NPRL will participate. In phase 1, NPRL will be developed and healthcare professionals educated. Phase 2 focusses on the implementation and phase 3 on the transferability of NPRL. In addition, preliminary data on patient's work status, general health and participation level will be collected. The qualitative results of each phase will be analysed following the Consolidated Framework for Implementation Research (CFIR) and will be used to refine NPRL in daily practise.

Ethics and dissemination: Informed consent will be obtained from all participants. The results of this feasibility study will form the basis for refinement of NPRL and planning of a large-scale process and effect evaluation of the Quadruple Aim outcomes. Dissemination will include publications and presentations at national and international conferences. Ethical approval for this study was granted by the Medical Ethics Committee Z, the Netherlands, METC 17 N-133.

Keywords: musculoskeletal disorders; organisation of health services; pain management; primary care; rehabilitation medicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chronic Disease
  • Delivery of Health Care, Integrated / methods*
  • Delivery of Health Care, Integrated / organization & administration
  • Feasibility Studies
  • Health Occupations / education*
  • Health Plan Implementation / organization & administration*
  • Humans
  • Musculoskeletal Pain / rehabilitation*
  • Netherlands
  • Organizational Objectives
  • Pain Management / methods
  • Research Design