Background: The ‘Improving the Wellbeing of people with Opioid Treated CHronic Pain’ (I-WOTCH) program, developed and tested in the UK, is effective and safe in reducing opioid use among people with chronic pain without worsening pain or daily functioning. However, successful implementation of complex interventions in other healthcare systems requires context-specific adaptation. This qualitative study aims to explore Australian clinicians’ perspectives on adapting I-WOTCH for local implementation, including perceptions of online delivery.
Methods: Semi-structured interviews were conducted with Australian clinicians with experience in prescribing, dispensing, or administering opioid analgesics. Sampling aimed for diversity in professional background, geographic location, and clinical experience. Interviews explored perceptions of the format, delivery, content, structure, feasibility, and acceptability of I-WOTCH. Deductive coding was guided by the Consolidated Framework for Implementation Research (CFIR 2.0), while parallel inductive coding captured perspectives beyond the framework. Findings were subsequently organised by selected categories from the Template for Intervention Description and Replication (TIDieR) checklist.
Results: Seventeen clinicians were recruited, representing diverse professional backgrounds and a broad range of clinical experience. Overall, clinicians broadly supported the I-WOTCH model for opioid tapering and chronic pain management but also suggested potential modifications to improve contextual fit. These mainly included strengthening holistic pain management strategies, enhancing multidisciplinary involvement and communication pathways, adapting delivery modalities, and refining group session structure. Participants also highlighted the importance of group support, therapeutic relationships, and peer facilitators in facilitating patient-centred opioid tapering.
Conclusions: Australian clinicians broadly supported adaptation of the I-WOTCH model but identified context-specific modifications to improve implementation feasibility and accessibility within the Australian context. Most proposed adaptations focused on intervention delivery and implementation strategies rather than substantive changes to intervention components. Together with future consumer input, these findings will inform co-design of an Australian-adapted I-WOTCH intervention and support subsequent evaluation within the Australian healthcare system.