https://orcid.org/0000-0002-9193-2297
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Abstract
Purpose
To identify and rank opportunities and challenges around adapting supported employment interventions for people with chronic low back pain (LBP).
Methods
Delegates from an international back and neck research forum were invited to join an expert panel. A modified nominal group technique (NGT) was used with four stages: silent generation, round robin, clarification, and ranking. Ranked items were reported back and ratified by the panel.
Results
Nine experienced researchers working in the fields related to LBP and disability joined the panel. Forty-eight items were generated and grouped into 12 categories of opportunities/challenges. Categories ranked most important related respectively to policy and legislation, ensuring operational integration across different systems, funding interventions, and managing attitudes towards work and health, workplace flexibility, availability of “good” work for this client group, dissonance between client and system aims, timing of interventions, and intervention development.
Conclusions
An expert panel believes the most important opportunities/challenges around adapting supporting employment interventions for people with chronic LBP are facilitating integration/communication between systems and institutions providing intervention components, optimising research outputs for informing policy needs, and encouraging discussion around funding mechanisms for research and interventions. Addressing these factors may help improve the quality and impact of future interventions.
Interaction pathways between health, employment, and social systems need to be improved to effectively deliver intervention components that necessarily span these systems.
Research-policy communication needs to be improved by researchers and policy makers, so that research outputs can be consumed by policy makers, and so that researchers recognise the gaps in knowledge needed to underpin policy.
Improvements in research-policy communication and coordination would facilitate the delivery of research output at a time when it is likely to make the most impact on policy-making.
Discussion and clarification surrounding funding mechanisms for research and interventions may facilitate innovation generally.
Implications for rehabilitation
Acknowledgements
Panel members, whose names are reproduced here with consent, were: Michiel Reneman, Rob Smeets, Gwenllian Wynne-Jones, Nadine Foster, Serena Bartys, Vigdis Sveinsdottir, Tone Langjordet Johnsen, Pål Andre Amundsen, and Michele Battie. Thanks are also due to Versus Arthritis, Kristiania University College, and University of Warwick who co-funded travel and attendance for RF. Authors are also grateful for contributions from J.Lunt Associates Ltd, and Margreth Grotle from Oslo Metropolitan University and Oslo University Hospital.
Author contributions
The study was conceived by RF, designed by RF, MU, KB, TP, and VS, administered by RF, MU, VS, TP, and PA. RF did the analysis and wrote the first draft of the paper. All authors contributed comments and edits to successive drafts.
Disclosure statement
RF and MU are part of an academic partnership with Serco Ltd related to return-to-work initiatives, and shareholders and directors of Clinvivo Ltd that provides electronic data collection for health services research. MU was Chair of the NICE accreditation advisory committee until March 2017 for which he received a fee. He is a chief investigator or co-investigator on multiple previous and current research grants, on low back pain and other disorders, from the UK National Institute for Health Research (NIHR), Arthritis Research UK and is a co-investigator on grants funded by the Australian NHMRC. He is an NIHR Senior Investigator. He has received travel expenses for speaking at conferences from the professional organisations hosting the conferences. He is a co-investigator on a study receiving support in kind from Orthospace Ltd. He is an editor of the NIHR journal series, and a member of the NIHR Journal Editors Group, for which he receives a fee. He has published multiple papers on chronic pain some of which are referenced in this paper. MFR is a steering group member of the EFIC Societal Impact of Pain Steering Group and co-chair of the Pain Alliance Netherlands. KB occasionally receives consultancy fees from occupational health providers, and is an expert advisor to the UK Department for Work and Pensions. NEF is a chief investigator or co-investigator on multiple previous and current research grants, on low back pain and other disorders, from the UK NIHR, Versus Arthritis, and other funders. She is an NIHR Senior Investigator. She has received travel expenses for speaking at conferences from the professional organisations hosting the conferences and has received research funding to develop, test and implement interventions that support people with musculoskeletal pain in staying at, and returning to, work. PA, TP, TLJ, VS, SB, MCB and GJ declare that they have no conflicts of interest.
The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, MRC, CCF, NETSCC, the Health Technology Assessment programme or the Department of Health and Social Care.
Data availability statement
The data that support the findings of this study are available from the corresponding author, RF upon reasonable request.