Health Care Leaders' Views About Remotely Delivered Cognitive Behavioral Therapy-Based Services for High-Impact Chronic Pain.

BACKGROUND: Chronic musculoskeletal pain remains a vexing clinical challenge, and health care systems have struggled to identify effective, scalable, and safe treatment alternatives to opioids and other higher-risk interventions. Remotely delivered cognitive behavioral therapy for chronic pain (CBT-CP) offers an evidence-based approach to meet this need. METHODS: The qualitative portion of the study aimed to advance understanding of how clinicians and health care system administrators perceive remotely delivered CBT-CP and to inform its dissemination and practical integration into health care systems. Specifically, semistructured interviews were conducted with 9 health care system representatives involved in chronic pain care as part of a large NIH-funded trial testing the comparative effectiveness of 2 CBT-CP interventions: online self-completed vs delivered by master's level behavioral health practitioners via phone/videoconferencing. RESULTS: Interviewees included clinicians, administrators, and staff involved in the delivery of care for chronic pain at the health care systems participating in the trial. They found both programs promising with good supporting evidence and felt that both could be helpful in alleviating staffing challenges, expanding therapeutic options, and providing access to chronic pain services in rural areas. CONCLUSIONS: In summary, evidence-based, remotely delivered CBT-CP interventions provide opportunities for closing care gaps and better meeting the needs of patients, particularly those residing in rural or other medically underserved areas. Health care leaders saw CBT-CP as an effective nonpharmacologic tool for improving care, and their perspectives can serve to guide the implementation and broad dissemination of these programs.