Process evaluation protocol for the I-WOTCH study: an opioid tapering support programme for people with chronic non-malignant pain

BMJ Open. 2019 Oct 10;9(10):e028998. doi: 10.1136/bmjopen-2019-028998.


Introduction: The Improving the Wellbeing of people with Opioid Treated CHronic Pain (I-WOTCH) randomised controlled trial uses a multicomponent self-management intervention to help people taper their opioid use. This approach is not widely used and its efficacy is unknown. A process evaluation alongside the trial will help to assess how the intervention was delivered, looking at the dose of intervention received and the fidelity of the delivery. We will explore how the intervention may have brought about change through the experiences of the participants receiving and the staff delivering the intervention and whether there were contextual factors involved.

Methods and analysis: A mixed methods process evaluation will assess how the processes of the I-WOTCH intervention fared and whether these affected the outcomes. We will collect quantitative data, for example, group attendance analysed with statistical methods. Qualitative data, for example, from interviews and feedback forms will be analysed using framework analysis. We will use a 'following a thread' and a mixed methods matrix for the final integrated analysis.

Ethics and dissemination: The I-WOTCH trial and process evaluation were granted full ethics approval by Yorkshire and The Humber-South Yorkshire Research Ethics Committee on 13 September 2016 (16/YH/0325). All data were collected in accordance with data protection guidelines. Participants provided written informed consent for the main trial, and all interviewees provided additional written informed consent. The results of the process evaluation will be published and presented at conferences.

Trial registration number: ISRCTN49470934; Pre-results.

Keywords: chronic non-malignant pain; opioids; process evaluation; protocol; tapering.

Publication types

  • Clinical Trial Protocol
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / therapeutic use
  • Chronic Pain / drug therapy*
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Pain Management / methods*
  • Randomized Controlled Trials as Topic
  • Self-Management
  • Treatment Outcome


  • Analgesics, Opioid

Associated data

  • ISRCTN/ISRCTN49470934