Exercise Prescribing for Persistent Pain in Older Adults: Protocol for a Stepped-Wedge Implementation Trial
DOI:
https://doi.org/10.5281/zenodo.22549204Keywords:
Persistent pain, Older adults, Exercise prescribing, Implementation science, Stepped-wedge trial, Study protocolAbstract
Structured exercise has strong guideline-level evidence as first-line management for common causes of
persistent pain in older adults, yet audit and observational literature consistently documents a substantial
gap between guideline recommendation and routine prescribing practice in this population. This
protocol describes a stepped-wedge cluster randomised implementation trial evaluating a structured
exercise-prescribing pathway, combining clinician training, decision support, and referral-pathway
simplification, against usual care across six primary and community care clinic sites. Sites will cross
over from control to intervention condition in a randomly allocated sequence over six time steps. The
primary outcome is patient-reported pain interference at twelve months; secondary and process
outcomes include physical function, exercise adherence, and clinic-level guideline-concordant
prescribing rate. This protocol is registered prospectively and reports the planned design, outcomes, and
analysis approach in advance of trial data collection.
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