Anticipated barriers and facilitators of implementing a digital behavioral treatment for chronic pain: a qualitative interview study

Clinical Snapshot

Key Findings

• P Value: Not applicable for qualitative research

• Effect Size: Not applicable for qualitative research

• Primary Outcome: 86 facilitators and 38 barriers to digital intervention implementation identified

• Nnt Or Sensitivity: High stakeholder openness to digital interventions with 2.3:1 facilitator to barrier ratio

• Confidence Interval: Not applicable for qualitative research

Clinical Application

Findings suggest high organizational readiness but require addressing training, decision-making processes, and needs assessment Relevant to Australian digital health initiatives; aligns with TGA digital therapeutics framework and RACGP chronic pain management guidelines Healthcare organizations implementing digital behavioral interventions for chronic pain management

Abstract

BACKGROUND: In digital health innovations, sustainable implementation should be considered from the initiation of the development to ensure that the solution fits into the existing healthcare system. This study aims at identifying barriers and facilitators for the prospective implementation of a digital behavioral intervention for chronic pain in the Swedish healthcare system, as perceived by key stakeholders. METHODS: Eight semi-structured individual interviews were conducted with stakeholders (n = 2 IT developers, n = 4 healthcare managers, n = 2 healthcare professionals). Qualitative data were analyzed using a framework analysis following the Consolidated Framework for Implementation Research (CFIR). RESULTS: A total of 86 facilitators and 38 barriers to prospective implementation were identified across stakeholder interviews. Facilitators included perceived relevance of the digital intervention and organizational readiness. Identified barriers primarily related to insufficient training and supervision, unclear decision-making processes (e.g., specific actions, responsibilities of stakeholders), and the lack of systematic needs assessment to guide implementation planning. CONCLUSION: Overall, findings indicate a high level of openness toward digital interventions within the implementation context. While implementation context largely demonstrates readiness, successful integration will depend on proactively addressing identified barriers. Awareness of these factors enhances the likelihood of successful and sustainable implementation.