623: Development of a Monitoring and Evaluation Plan for a Chronic Pain Care Program

Topic: Education, Societal Impact, and Others
Subtopic: Organisation of clinical pain care

Background and Aims: Chronic pain affects approximately 40% of Brazilian adults and represents a major public health challenge. Although multidisciplinary pain services are available in some public institutions, systematic monitoring and evaluation processes remain limited, affecting care quality and program sustainability. Structured evaluation strategies are necessary to improve clinical outcomes, safety, and continuity of care for individuals living with chronic pain. This project aims to develop and implement a Monitoring and Evaluation Plan for a chronic pain program within the Brazilian public health system.

Methods: Mixed-methods study using a sequential exploratory design (qualitative followed by quantitative phases), conducted at the pain clinic of the Instituto Nacional de Traumatologia e Ortopedia.
The study includes three phases:
Assessment of organizational readiness and identification of barriers and facilitators for implementation;
Participatory development of a program logic model and theory of change;
Implementation of monitoring indicators and program evaluation using implementation science frameworks.
Participants include multidisciplinary healthcare professionals and adult patients receiving outpatient chronic pain care.

Results: The project is expected to:

• Improve care standardization and monitoring
• Enhance functional and patient-centered outcomes
• Support safer and more rational opioid use
• Strengthen multidisciplinary collaboration
• Improve patient satisfaction and continuity of care

The model may support expansion of structured chronic pain programs within public health services.

Conclusions: Implementation of structured monitoring and evaluation processes may strengthen chronic pain programs, promoting safer, evidence-based, and patient-centered care in public health settings.

References: 1. Geetha K, Rehan H, Asghar M, Zameer A, Sambreen Z. Innovative approaches in chronic pain management. I-Manager’s Journal on Life Sciences (JLS) 2024;3:19. https://doi.org/10.26634/jls.3.2.20964.
2. Aguiar DP, Queiroz Souza CP, Barbosa WJM, Santos-Júnior FFU, Oliveira AS. Prevalência de dor crônica no Brasil: revisão sistemática. BrJP. 2021;4(3):257-67. DOI: 10.5935/2595-0118.20210041.
3. Ministério da Saúde (BR). Protocolo Clínico e Diretrizes Terapêuticas da Dor Crônica. Brasília: Ministério da Saúde; [citado em 27 de julho de 2025]; 2024. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/sctie/2024/prt0001_23_08_2024.html.
4. Connell N, Prathivadi P, Lorenz KA, Zupanc SN, Singer SJ, Krebs EE, et al. Teaming in Interdisciplinary Chronic Pain Management Interventions in Primary Care: a Systematic Review of Randomized Controlled Trials. Journal of General Internal Medicine 2022;37:1501–12. https://doi.org/10.1007/s11606-021-07255-w.</div>.
5. National Guideline Centre (UK). Evidence review for pain management programmes for chronic pain (chronic primary pain and chronic secondary pain): Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain: Evidence review C. London: National Institute for Health and Care Excellence (NICE) ; [citado em 27 de julho de 2025]; 2021 Apr. (NICE Guideline, No. 193.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK569980/.
6. Maser D, Müßgens D, Kleine-Borgmann J, et al. Setting the stage for pain relief: how treatment setting impacts interdisciplinary multimodal pain treatment for patients with chronic back pain. Pain. 2024;165(12):2909-2919. doi:10.1097/j.pain.0000000000003318.
7. Organização Pan-Americana da Saúde e Ministério da Saúde. Monitoramento e Avaliação em Promoção da Saúde. Brasília, D.F. ; [citado em 27 de julho de 2025]; 2024. Disponível em: https://doi.org/10.37774/9789275129227.
8. Danforth K, Ahmad AM, Blanchet K, et al. Monitoring and evaluating the implementation of essential packages of health services. BMJ Global Health 2023;8:e010726. doi:10.1136/ bmjgh-2022-010726.
9. Reynolds HW, Sutherland EG. A systematic approach to the planning, implementation, monitoring, and evaluation of integrated health services. BMC Health Serv Res. 2013;13:168. Published 2013 May 6. doi:10.1186/1472-6963-13-168.
10. Weiner BJ. A theory of organizational readiness for change. Implement Sci. 2009;4:67. Published 2009 Oct 19. doi:10.1186/1748-5908-4-67.
11. Organização das Nações Unidas (ONU). Transformando Nosso Mundo: A Agenda 2030 para o Desenvolvimento Sustentável. Assembleia Geral das Nações Unidas. 2015. [citado 27 de julho de 2025]. Disponível em: https://brasil.un.org/pt-br/sdgs.
12. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis. Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas e Agravos não Transmissíveis no Brasil 2021-2030; [citado 27 de julho de 2025]; 2021. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/doencas-cronicas-nao-transmissiveis-dcnt/09-plano-de-dant-2022_2030.pdf/view.
13. International Federation of Red Cross and Red Crescent Societies. Project/programme monitoring and evaluation (M&E) guide. Geneva: IFRC; [citado 27 de julho de 2025]; 2011. Available from: http://www.ifrc.org.
14. Antunes JdM, Daher DV, Moraes ÉBd, Ferrari MFM, Geraldo MdA.Programa Integrador e o cuidado de enfermagem frente à dor crônica:relato de experiência. Enferm Foco. 2020;11(5):48-53. doi:https://doi.org/10.21675/2357-707X.2020.v11.n4.3376.
15. Peixoto, L. S., et al. Adaptação transcultural e validação do instrumento Organizational Readiness for Implementing Change (ORIC) para o contexto brasileiro. Revista Latino-Americana de Enfermagem, 2019.
16. Damschroder LJ, Aron DC, Keith RE, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science. 2009;4:50.

Presenting Author: Barbara Ventura Fontes
Submitting Author: Barbara Fontes

Senior Author: Erica Brandão de Moraes

IASP 2026 Global Year theme of Neuropathic Pain: No

• Erica Brandão de Moraes: PhD/Doctoral - Fluminense Federal University
• Maria Fernanda Muniz Ferrari: PhD/Doctoral - National Institute of Traumatology and Orthopedics
• Marina de Almeida Geraldo: Bachelor's degree - National Institute of Traumatology and Orthopedics/Fluminense Federal University