Project Portugal 2030

Summary

This project aims to co-design and assess a digital intervention (InControl) based on pain neuroscience education (PNE) and physical exercise for older adults with chronic pain and facilitate the implementation and sustainability of innovative high-value healthcare for all. To achieve this overall aim, we will: 1. Define the technical requirements, main components, interfaces, and data models to support the front and back-office information services of the InControl. 2. Adapt the back and front office apps of an existing digital solution that already meets security requirements. 3. Develop the InControl digital content and define its administration principles in a co-design approach with older adults with pain, GPs, and physiotherapists (stakeholders). 4. Assess the usability and user experience of the InControl digital solution with end-users and with experts in usability in a continuous, iterative, and progressive (from a controlled environment to the real context of use) way. 5. Train health professionals with up-to-date knowledge of pain science, and to deliver the InControl contributing to the transferability of knowledge to clinical practice. 6. Evaluate quantitatively and qualitatively the clinical effectiveness of the InControl digital intervention. 7. Evaluate the cost-effectiveness of the InControl digital intervention. 8. Determine factors associated with adhesion to the InControl in particular and with digital interventions, in general; 9. Explore the potential impact of InControl on cognitive functioning. The PI, NPR and NeuroInova are involved in a three-arm RCT in low back pain and a preliminary data analysis suggests that PNE and exercise have a positive impact on cognitive function like that of cognitive training. Considering that older adults are at increased risk for cognitive disorders and that pain negatively affects cognitive function, we believe this association is worthwhile exploring. A systematic review of our team found only 3 studies looking at whether pain management impacted cognitive function. This exploratory analysis can set the base for a future project. 10. Disseminate findings among stakeholders. This proposal addresses several relevant challenges in an innovative way, including: i) the high prevalence and impact of pain across all domains of life by designing a pain-management intervention based on the best available evidence; ii) the lack of pain management interventions directed at older adults both in Portugal and worldwide; iii) the current burden faced by health services and health professionals which requires healthcare strategies that increase the reach of the services and maintains the quality of care while lowering the costs and the burden; iv) the slow translation of research into clinical practice - by bringing health professionals into the project and having a task dedicated to training, this project facilitates the translation of research into clinical practice improving the quality of care; v) the concerns of health professionals regarding the digital interventions, data security and privacy – by partnering with end users our project will help demystify existing concerns; vi) the short life of digital solutions developed in scientific projects – by partnering with a business company that already commercializes digital interventions the long-term sustainability is assured.