Background & Aims
Chronic low back pain (CLBP) remains a significant public health problem and is associated with the highest number of years lived with disabilities (YLDs) worldwide. Recent evidence indicates the effectiveness of interprofessional rehabilitation programs in reducing pain, improving health-related quality of life, function, and work abilities for people with CLBP. However, interprofessional rehabilitation programs vary greatly in the literature, making it challenging to implement the evidence in new settings, especially in low- and middle-income countries such as Ethiopia, where the context differs from those countries in which interprofessional rehabilitation programs have been evaluated. Therefore, it’s imperative to identify, develop, and evaluate an interprofessional rehabilitation program tailored to the Ethiopian context. This research aimed to develop tailored evidence and theory-informed interprofessional rehabilitation program for people with CLBP in the Ethiopian context.
Methods
A systematic and rigorous approach guided by the UK Medical Research Council (MRC) framework for developing and evaluating complex interventions was followed. Accordingly, stepwise multiple methodological approaches were employed in this research project. In the first step, a scoping review was done with the aim of synthesizing the characteristics and theoretical foundations of interprofessional rehabilitation programs for people with CLBP evaluated in the literature. We then conducted a two-round modified Delphi technique to achieve consensus amongst multiple stakeholders on the components of an interprofessional rehabilitation program. Findings from a scoping review were used to develop the round one survey question. After the modified Delphi, semi-structured interviews and focus group discussions were conducted with healthcare professionals and people with CLBP to ensure that the interprofessional rehabilitation components are implementable and acceptable in real-world practice.
Results
The development process of an interprofessional rehabilitation program for people with CLBP considered available evidence, clinical experience, and the engagement of multiple stakeholders, including care providers, pain experts, and people with CLBP as co-creators of the intervention. The final interprofessional rehabilitation program for people with CLBP consists of multiple components, including graded physical activities and exercises, pain education, psychotherapy, occupational therapy, ergonomic interventions, and vocational support. In addition, consensus was reached on therapeutic goals, interprofessional team members, intervention delivery mode, duration, frequency, and intensity of the interventions, and theoretical foundations of interprofessional rehabilitation program for people with CLBP in the Ethiopian context.
Conclusions
This study provides a comprehensive overview of how a tailored evidence and theory-informed interprofessional rehabilitation program for people with CLBP is developed in the Ethiopian context. The methodology used may provide a valuable roadmap for the development of interprofessional rehabilitation programs tailored to other contexts. In an additional step, the intervention’s feasibility, acceptability, and implementation strategies are currently being tested in a pilot randomized control with an accompanying process evaluation.
References
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Presenting Author
Jordan Miller
Poster Authors
Sintayehu Wami
PhD Candidate
Queen's University
Lead Author
Catherine Donnelly (PhD)
Queen's University
Lead Author
Kasahun Gelaye (PhD)
University of Gondar
Lead Author
Esayas Adefris (MD)
University of Gondar
Lead Author
Jordan Miller
BSc
Queen’s University
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Low Back Pain