PRIMARY HEALTHCARE PROVIDERS’ ORGANISATIONAL READINESS TO IMPLEMENT AN ONLINE PAIN NEUROSCIENCE EDUCATION PROGRAMME IN THE BRAZILIAN PUBLIC HEALTH

M. P. Baroni^1,2,3, B.C. Gallon¹, R. Aiello Bomfim⁴, L.H. Espanhol^2,5, F. Reis⁶, C. R. Daniel^1,7, S. de Andrade Melo Knaut¹, J. Vitorino Fandim², B. T. Saragiotto^2,3,8

¹Universidade Estadual do Centro Oeste do Parana, Department of Physiotherapy, Guarapuava, Brazil, ²Universidade Cidade de São Paulo (UNICID), Masters and Doctoral Programs in Physical Therapy, São Paulo, SP, Brazil, ³Centre for Pain, Health and Lifestyle, São Paulo, Brazil, ⁴Universidade Federal do Mato Grosso do Sul (UFMG), School of Dentistry, Campo Grande, MS, Brazil, ⁵Amsterdam University Medical Centers (UMC) Location VU University Medical Center Amsterdam (VUmc), Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam, Netherlands, ⁶Instituto Federal do Rio de Janeiro, Department of Physical Therapy, Rio de Janeiro, RJ, Brazil, ⁷University of São Paulo (USP), Postgraduate Program in Medical Sciences, São Paulo, Brazil, ⁸University of Sydney, Institute for Musculoskeletal Health, Sydney, Australia

Background: Clinical practice guidelines currently recommend pain neuroscience education, physical and psychological therapies as the first-line treatment for chronic musculoskeletal pain. Thus, we are implementing an online pain neuroscience education programme, named EducaDor Programme, for those individuals with musculoskeletal chronic pain referred to physiotherapy in the Brazilian Unified Health System (SUS) of Guarapuava city. However, measuring organisational readiness for implementing a new service is the beginning stage of an implementation strategy. It helps the management to take the necessary steps to build the organisation ready for change.

Purpose: To assess primary healthcare providers’ organisational readiness to refer patients with chronic musculoskeletal pain to an online pain neuroscience education programme (EducaDorProgramme) in Brazilian public health.

Methods: This is a cross-sectional study following the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). The EducaDorProgramme will be delivered once a week, synchronous or asynchronous, for 10-week, and will be available in the digital medical records system in the Guarapuava’ SUS. Then, the primary healthcare providers of Family Health teams can refer SUS’ users with chronic musculoskeletal pain to the EducaDor Program. Fifity-nine healthcare providers of Family Health teams were invited to attend a face-to-face meeting explaining the EducaDorProgramme. An online questionnaire was applied to collect the data about characteristics of the sample and Organisational Readiness for Implementing Change questionnaire (ORIC). The ORIC questionnaire contains 11 items that correspond to the domains of commitment and efficacy. The ORIC questionnaire uses a 5-point Likert scale (1 = strongly disagree, and 5 = strongly agree) for each factor. The change commitment and change efficacy were analysed in terms of means (mean scores more than four indicates good organizational readiness for each domain) and proportions (more than 50% of respondents considering scores of four or more for each domain).

Results: 40 primary healthcare providers of 15 Family Health teams of Guarapuava’ SUS participated in the study. The average age was 32.8±8.7 years old, attending 7.6±8.1 years in the public health, 70% (n=28) were post-graduate, and 87.5% (n=35) were woman. The commitment and efficacy mean scores were 3.83±1.1 and 3.65±1.09 points, respectively. Scores of four points or more for commitment were observed in 40% (n=16) of the respondents, and for efficacy in only 5% (n=2). When participants were grouped by the respectively Family Health teams, we observed that 7 (46.7%) Family Health teams had scores lower of four points for commitment, and 8 (53.3%) for efficacy.

Conclusions: There is medium organisational readiness for implementing the referral of individuals with musculoskeletal chronic pain to EducaDorProgramme by the primary healthcare providers of Family Health teams.

Implications: The primary healthcare providers of Family Health teams of Guarapuava’ SUS must be better prepared to guarantee the success and sustainability of the EducaDorProgramme.Continuous monitoring and training will be offered to primary healthcare providers to ensure greater preparation and success in the program.

Funding acknowledgements: Research Programme for SUS: Health shared management – PPSUS; Graduate Support Programme of Private Educational Institutions (PROSUP/CAPES); São Paulo Research Foundation

Keywords:
Chronic pain
Health education
Implementation science

Topics:
Pain & pain management
Globalisation: health systems, policies & strategies
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: Universidade Estadual do Centro-Oeste

Committee: Research Ethics Committee of Universidade Estadual do Centro-Oeste

Ethics number: CAAE 11975019.0.0000.0106