261: Co?Creating a Chronic Pain Care Model for Multicultural Primary Care in Australia

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Non-pharmacological treatments, Physiotherapy (e.g. exercise, rehab), Treatment/management

Background and Aims: Interdisciplinary care is recommended for chronic pain but is commonly delivered in tertiary settings with substantial barriers to access[1]. Consequently, most people are managed in primary care where resources (e.g., time, expertise) required for coordinating and sustaining multidisciplinary collaboration, particularly for culturally and linguistically diverse (CALD) communities, are limited[2]. Existing primary care pain programs are seldom informed by consumers or incorporate cultural responsiveness and are inconsistently delivered and evaluated[3]. This qualitative study aimed to inform the design of a chronic pain model of care in multicultural Australian primary care by engaging patients, carers, primary healthcare professionals and tertiary pain services.

Methods: Purposive sampling recruited patients (n=13), carers (n=2), primary healthcare professionals (n=19), and tertiary persistent pain team members (n=20). Semi-structured interviews and focus groups explored program needs, cultural considerations, preferred delivery methods, and barriers and enablers to implementation. Transcripts were analysed using reflexive thematic analysis. Themes relating to program design and implementation determinants were mapped to the Consolidated Framework for Implementation Research (CFIR) to identify influences at intervention, individual, inner/outer setting, and process levels[4]. Member checking supported credibility. Sociodemographic and clinical characteristics were summarised descriptively.

Results: Participants were culturally diverse (non-Caucasian ethnicity n=12; language other than English n=5). Healthcare professionals (mean experience 15 ±14 years) represented 10 disciplines with 21/39 having postgraduate pain training and 11 (28%) with formal CALD training. Program design needs and preferences were grouped into three themes: Content (pain education, self-management, system navigation, social supports); Delivery (blended group/individual options, flexible entry, language accessibility, peer support); and Personnel (General Practitioner coordination, allied health facilitation, integrated psychological and social care). CFIR-aligned determinants included beliefs about outcomes, funding, service integration, time constraints, user motivation, capabilities, referral decision-making, program promotion, workforce training, program supports.

Conclusions: This large qualitative study has generated recommendations for a culturally responsive, primary care–based chronic pain model of care and implementation strategy. Key features included multilingual educational resources, flexible delivery modes, coordinated multidisciplinary roles, GP-led referral pathways, capability building with supervision, and structured program supports to ensure consistent messaging. CFIR mapping clarified modifiable barriers and facilitators across clinical and organisational contexts, informing practical strategies for adoption and sustainability. The model provides a feasible, scalable framework for improving equitable chronic pain care in multicultural communities and will next be piloted to evaluate feasibility, acceptability, clinical impact, and implementation outcomes.

References: 1. Hogg, MN, et al., 2021. Waiting in pain II: an updated review of the provision of persistent pain services in Australia. Pain Medicine, 22:1367-75.
2. AIHW. 2020. Chronic Pain in Australia. In, edited by Australian Institute of Health and Welfare. Canberra: AIHW.
3. Walker, P. et al., 2022. Chronic pain and cardiovascular disease prevention in primary care: a review of Australian primary health network needs assessments. Australian Health Review, 46:70-77.
4. Damschroder, LJ., et al., 2022. The updated Consolidated Framework for Implementation Research based on user feedback. Implementation Science, 17:75.

Presenting Author: Leanne Bisset
Submitting Author: Leanne Bisset

Senior Author: Leanne Bisset

IASP 2026 Global Year theme of Neuropathic Pain: No

• Joan Kelly: PhD - Griffith University
• Samantha Bunzli: PhD - Griffith University
• Hayley Thomson: M Med Res - Healthia Ltd
• Amanuiel Taddese: BSci (Hons) - The University of Queensland
• Kerrie Evans: PhD - Healthia Ltd
• Tracey Johnson: Masters - Inala Primary Care
• David Chua: PhD - Inala Primary Care
• Jamie Nuttal: MBBS - Inala Primary Care
• Nicholas Aitcheson: MBBS - Metro South Hospital Health Service