Exploring the views of stakeholders about the feasibility of carrying out a randomised controlled trial of Individual Placement and Support for people unemployed with chronic pain based in primary care (the InSTEP study)

Abstract

Background: Individual Placement and Support (IPS) is a model of vocational rehabilitation originally developed to help people with severe mental illness obtain and maintain employment. Work disability is common amongst people with chronic pain conditions, yet few effective interventions exist. As part of mixed-methods feasibility research and as a forerunner to a pilot trial (In STEP), we investigated the barriers and facilitators to carrying out a future randomised controlled trial of IPS set in primary care amongst people unemployed with chronic pain. Methods: Semi-structured interviews and focus groups were conducted with: unemployed people with health conditions receiving IPS (clients), Employment Support Workers (ESWs) delivering IPS for people with chronic health conditions and primary healthcare professionals. Interviews and focus groups were transcribed verbatim and analysed with field notes using thematic analysis.(Continued on next page)

A pilot trial investigating the feasibility of a future randomised controlled trial of Individualised Placement and Support for people unemployed with chronic pain recruiting in primary care

“…Taking all this into account, it is challenging to know when best a workplace intervention should be offered. Either way, as was suggested in our qualitative work with people with chronic pain (Holmes et al, 2020), follow-up over 12 months may be too soon to fully appreciate the effectiveness of IPS on return to work in a trial, and assessment of employment status at 24 months or longer may be a more appropriate primary outcome, as used by Hellstrom and co-workers in their study of IPS in people with mood and anxiety disorders (Hellstrom et al, 2017). We experienced difficulty in obtaining responses to follow-up questionnaires (40% non-receipt) despite incentives and reminders, with rates of attrition similar to those seen in a similar study (Froud et al, 2020).…”