Integrating interventions based on cognitive behavioural therapy for insomnia in physical therapist practice for individuals with chronic pain and insomnia: Identifying barriers and formulating implementation strategies.
Marine Markaryan, Céline Labie, Sabine Verschueren and 9 others
PMID 40886588WHAT IT FOUND
Stakeholders identified 33 barriers to physical therapists delivering CBT for insomnia in chronic pain patients, including lack of training, no reimbursement, and patient preference for pills.
They proposed 13 strategies, prioritizing mentorship, guideline changes, and awareness campaigns.
Key findings
01The study identified 33 barriers to implementing CBT-I in physical therapy practice and formulated 13 implementation strategies to address them.
02Top priority strategies focused on education and training for physical therapists, structural level changes, and raising awareness among general practitioners and the general population.
03Key barriers included the complexity of CBT-I, lack of reimbursement for physical therapists, dominance of traditional biomedical approaches in physical therapy, and patient preference for medication.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was conducted in Belgium, so the findings on reimbursement and healthcare system barriers may not transfer directly to other countries. The sample size of 16 stakeholders is small, though it was purposefully selected to include diverse perspectives. The study identifies barriers and proposes strategies but does not test whether these strategies actually improve implementation or patient outcomes. Two physical therapists dropped out during the process, and one did not complete the ranking stage, potentially affecting the final prioritization.
Declared interests
Several authors receive financial support from the Research Foundation Flanders (FWO). Jo Nijs and Vrije Universiteit Brussel have been compensated for lectures by professional and educational organizations. ChatGPT was used for language correction.
The easy way to misread this
Do not interpret the identified strategies as evidence that physical therapist-delivered CBT-I is effective or currently reimbursable. This study reports on the barriers to implementation and proposes solutions, but it does not measure clinical outcomes or test the efficacy of the proposed strategies.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →