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Currently submitted to: JMIR Human Factors

Date Submitted: Jun 17, 2020
(closed for review but you can still tweet)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Exploring the feasibility of relapse prevention strategies in interdisciplinary multimodal pain therapy programs: A qualitative study

  • Stefan Elbers; 
  • Jan Pool; 
  • Harriet Wittink; 
  • Albère Köke; 
  • Rob Smeets; 



Although interdisciplinary multimodal pain treatment (IMPT) programs are widely regarded as treatment of choice for patients with chronic pain, there are signs that many patients are unable to maintain their treatment gains in the long term. To facilitate the maintenance of positive treatment outcomes over time, we developed two relapse prevention strategies.


The main objective of this study was to explore the feasibility of these strategies within the context of IMPT programs.


We performed a feasibility study using three workbook prototypes containing either one or both strategies. For a period of 6 months, the workbooks were made available in two IMPT facilities. Qualitative data were collected through a focus group and semi-structured interviews. We performed a thematic analysis using a deductive approach with (1) applicability to the treatment program, (2) acceptability of the workbook content, and (3) form, as predefined themes.


The final dataset consisted of transcripts from a focus group with healthcare providers, eleven telephone interviews and two extra in-depth interviews with patients. In general, the intervention was perceived as useful, easy to use and in line with the treatment program. The data also include suggestions to further improve the use of both strategies, including more specific implementation guidelines, a revised goal-setting procedure and the development of a mobile-health version. However, several factors, including a high dropout rate a small sample size impact the external validity of our findings.


This study should be regarded as a first step in the process of transforming the prototype workbook into an effective intervention for clinical practice. Although these initial results indicate a favorable evaluation of both behavior regulation strategies within the workbook, this study encountered multiple barriers regarding implementation and data collection that limit the generalizability of these results. Future research efforts should specifically address the fidelity of HCPs and patients and should include clear procedures regarding recruitment and use of both relapse prevention strategies during treatment.


Please cite as:

Elbers S, Pool J, Wittink H, Köke A, Smeets R

Exploring the feasibility of relapse prevention strategies in interdisciplinary multimodal pain therapy programs: A qualitative study

JMIR Preprints. 17/06/2020:21545


Per the author's request the PDF is not available.