Pilot testing a pain science education resource in real-world physiotherapy clinics.

A single-arm, pragmatic, pilot feasibility study was used to evaluate the PainPLaN resource in real-world private-practice physiotherapy settings. PainPLaN is an educational resource designed to support the delivery of pain science education (PSE) in physiotherapy settings. The PainPLaN resource involved two-parts. Both parts of the resource were co-designed (by physiotherapists and patients with pain) specifically for this study. Part A included a suite of ten PDF infographic sheets, each covering a key PSE concept or topic. Each sheet provided content knowledge, supported by diagrams and pictures, as well as activities or tasks to facilitate deeper personalised learning, and an ‘Extra resources’ section with QR codes linking to other verified resources for further learning. Infographic sheets were designed to be self-explanatory, so could be discussed in appointment time or sent home with the patient. Part B was an action plan builder, that enabled physiotherapists to create personalised plans for patients. Physiotherapists were able to filter a central hub of over 200 existing PSE resources (e.g., videos, websites, podcasts etc), and then select specific resources to prescribe on given days. The data selected allowed generation of a one-page ‘PLaN’ where QR codes for the selected resources automatically prefilled into a calendar layout for the patient to use. Notes, personalisation (e.g., patient initials, goal setting), and lifestyle and management items (e.g., exercise, appointment reminders) were also able to be added. Both Part A and B could be printed or shared electronically. Study physiotherapists (registered, PSE-trained) underwent a short onboarding phase involving brief training on how to use PainPLaN, followed by a competancy task. The training was delivered via a training video outlining study procedures and step-by-step instructions for accessing and using PainPLaN on their own computers (~13 minutes), supplemented by a written guide summarising key study details. Competency was assessed by the lead researcher (MVW), based on physiotherapists’ completion of an action plan (and information sheet selection) for a patient scenario (~10 minutes), followed by a review of patient recruitment procedures. Physiotherapists were given five days to complete the onboarding/training tasks and to ask any questions. They were then provided with the PainPLaN resource to use with their patients (new or existing) during routine appointments at their private-practice clinics (Australia-wide) over a 4-week period. Study physiotherapists could use the resource at their discretion with any of their patients that attended 1:1 appointments in their private practice over the 4-week period. The resource was designed to be used in conjunction with other typical care and could be used within appointment time and/or sent home with the patient. Physiotherapists were encouraged to use PainPLaN across multiple appointments with returning patients if appropriate. Patients could interact with the PainPLaN resource however they wished in their own time. While PainPLaN could be used with any patient, those with chronic or recurrent pain (specified inclusion criteria) were eligible to participate in the study and provide feedback. Study physiotherapists explained to these patients that they were invited to participate in a research project to provide feedback on the resource and that participation was voluntary. Patients could be recruited at any point across the physiotherapists’ 4-week study period, i.e., patients commenced the study on a rolling basis, and were each followed for a 4 weeks. For each day worked within the 4-week study period, study physiotherapists completed a brief Daily Log, capturing tallies of clinical activity and overall PainPLaN use. Clinical activity data included hours worked, number of 1:1 appointments, number of patients with chronic/recurrent pain seen in 1:1 appointments, number of those patients with whom PainPLaN was used, and instances of PainPLaN use in group settings.