NURS FPX 8004 Assessment 3 Annotated Bibliography - Capella DNP.pdf

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1. NURS FPX 8004 Assessment 3 Annotated Bibliography
Student Name
Capella University
NURS-FPX8004
Professor Name
Submission Date







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2. Introduction
Pain management is a persistent challenge in inpatient rehabilitation facilities (IRFs), where
delays in intervention and inconsistent use of conservative approaches often limit patient
progress. Insufficiently managed pain not only diminishes comfort but also undermines
participation in therapy, prolonging recovery and reducing functional outcomes (Janevic et al.,
2025). Patients, clinicians, and administrators all face the consequences of fragmented protocols
and variable adherence to best practices. To address these challenges, the following PICO(T)
question guides this project: In nursing personnel working in inpatient rehabilitation centers (P),
how does implementing an opt-out policy for conservative pain management protocols (I),
compared with current practice (C), affect response time to pain interventions (O) over 12 weeks
(T)? Building an annotated bibliography provides the evidence base to evaluate strategies that
support timely, patient-centered, and evidence-informed approaches to pain control.
Strategy for Literature Search
The evidence review was conducted across PubMed, CINAHL, Cochrane Library, and
PsycINFO. Search terms included pain management, rehabilitation, nursing interventions,
conservative therapy, opioid reduction, and collaborative care. Boolean operators (e.g., pain
protocols AND nursing, chronic pain AND rehabilitation) refined the scope. The initial yield of
247 studies was narrowed using inclusion criteria: peer-reviewed articles published between
2020–2025, adult populations in rehabilitation or healthcare facilities, and focus on conservative
pain management or opioid minimization. Exclusion criteria removed pediatric studies, acute
care settings, and non-English publications. Ultimately, eight high-quality articles were selected,
representing diverse but complementary strategies including stepped-care sequencing, telehealth
models, interdisciplinary collaboration, and patient-driven self-management.
Annotated Bibliography
Ashworth, J., Cornwall, N., Jinks, C., & Mallen, C. D. (2025). Evaluating a primary care
pharmacist-led intervention to reduce opioid use for persistent non-cancer pain: The PROMPPT
cluster randomized controlled trial protocol. NIHR Open Research.
https://doi.org/10.3310/nihropenres.13441.1
This trial introduces pharmacist-led reviews for patients on long-term opioids, comparing usual
care with structured conservative management support. With 38 randomized sites, outcomes
include dose reduction and pain stability. The study’s pragmatic design strengthens
generalizability and highlights pharmacists’ role in interdisciplinary pain care. Though adherence
outcomes are pending, its relevance lies in offering scalable frameworks for embedding
collaborative, non-opioid interventions into routine practice in IRFs.
Clark, J. D., Bair, M. J., Lévy, I., Fitzsimmons, C., Zehm, L. M., Dougherty, P. E., … Shih,
M. (2023). Sequential and comparative evaluation of pain treatment effectiveness response

3. (SCEPTER), a pragmatic trial for conservative chronic low back pain treatment. Contemporary
Clinical Trials, 125, 107041. https://doi.org/10.1016/j.cct.2022.107041
The SCEPTER trial studied a stepped-care model with 2,529 veterans experiencing chronic low
back pain. Initial phases involved self-management and physical therapy, with escalation to
CBT, chiropractic, or yoga for nonresponders. Results validated sequencing as cost-effective and
clinically significant. Although veteran-specific, the findings provide strong support for protocol-
driven conservative care models that can be adapted for rehabilitation facilities, reducing
overreliance on pharmacological treatments.
Elphinston, R. A., Sterling, M., Leung, J., Gray, P. D., Requena, S., & Connor, J. P. (2021).
Brief psychological interventions for reducing prescription opioid use, related harm, and pain
intensity in patients with chronic pain: A systematic review. The Clinical Journal of Pain, 37(4),
270–280. https://doi.org/10.1097/AJP.0000000000000908
This systematic review assessed short psychological interventions for chronic pain and opioid
reduction. Across six included studies, moderate decreases in opioid use were observed, and
most patients expressed willingness to engage in psychological care. While methodological
variability limits certainty, the review highlights patient acceptance of nonpharmacologic
strategies, underscoring opportunities to expand behavioral approaches in rehabilitation-based
pain management.
Janevic, M. R., Lindsay, R., Brines, E., Wisdom, K., Lane, S. G., Brewer, R., … Latimer, C.
(2025). A community health worker-delivered intervention (STEPS) to support chronic pain self-
management among older adults in an underserved urban community: Protocol for a randomized
trial. Trials, 26, 186. https://doi.org/10.1186/s13063-025-08892-w
The STEPS protocol leverages community health workers to deliver self-management support to
older adults with chronic pain. Components include video education, coaching calls, and
referrals addressing social determinants. While outcomes are pending, the program demonstrates
innovation in equity-driven care and highlights culturally sensitive, community-based strategies.
This model is relevant to rehabilitation facilities seeking to expand engagement among diverse
and underserved populations.
Morasco, B. J., Pal, N., Ono, S. S., McPherson, S. M., Lynch, F. L., Dickerson, J. F., …
Mixon, A. S. (2024). Tele-collaborative outreach to rural patients with chronic pain: Pragmatic
effectiveness trial protocol for the CORPs study. Pain Medicine, 25(1), 91–98.
https://doi.org/10.1093/pm/pnae075
The CORPs trial tests a tele-collaborative model for veterans with chronic pain in rural regions.
The program integrates nursing coordination, physician oversight, and patient education for 608
participants. Although in protocol stage, the trial offers a replicable, scalable design for
extending specialty pain care to underserved areas. Its relevance lies in showcasing how
telehealth can bridge access gaps for rehabilitation populations.

4. Rogers, D. G., Frank, J. W., Wesolowicz, D. M., Nolan, C., Schroeder, A., Falker, C., …
Edmond, S. N. (2023). Video-telecare collaborative pain management during COVID-19: A
single-arm feasibility study. BMC Primary Care, 24, 134. https://doi.org/10.1186/s12875-023-
02052-2
This feasibility study evaluated a virtual pain management program (VCPM) for 133 veterans on
high-dose opioids during COVID-19. Interventions included tapering support, buprenorphine
initiation, and behavioral therapy. Results showed significant opioid reductions and high patient
satisfaction. Although limited by single-arm design, findings demonstrate telehealth’s potential
to deliver effective, multidisciplinary pain care under resource constraints.
Sellinger, J. J., Martino, S., Lazar, C., Mattocks, K., Rando, K., Serowik, K., … Becker, W.
C. (2021). The acceptability and feasibility of screening, brief intervention, and referral to
treatment for pain management among New England veterans with chronic pain: A pilot study.
Pain Practice, 22(1), 28–38. https://doi.org/10.1111/papr.13023
This pilot implemented the SBIRT-PM model—screening, motivational interviewing, and
referral—for 40 veterans with chronic pain. High satisfaction and adherence were reported, with
most participants completing follow-ups. Although limited in scope, the study highlights
motivational interviewing as a practical tool to increase adherence to conservative therapies,
reinforcing its integration into rehabilitation workflows.
Wilson, M., Dolor, R. J., Lewis, D., Regan, S. L., Meulen, M. B., & Winhusen, T. J. (2023).
Opioid dose and pain effects of an online pain self-management program to augment usual care
in adults with chronic pain: A multisite randomized clinical trial. Pain, 164(4), 877–885.
https://doi.org/10.1097/j.pain.0000000000002785
This multisite RCT evaluated the Goalistics online self-management program in 402 adults on
long-term opioids. Compared with usual care, participants achieved greater opioid dose
reductions without worsening pain. Results offer strong evidence for digital interventions that
empower patients, reduce medication reliance, and improve outcomes, making them highly
applicable to rehabilitation centers seeking patient-driven solutions.
Conclusion
The reviewed studies collectively reinforce the effectiveness of conservative and
interdisciplinary pain strategies in reducing opioid use and enhancing functional recovery.
Evidence supports stepped-care sequencing, psychological interventions, and technology-based
tools as effective, scalable solutions. Equity-focused initiatives demonstrate the importance of
addressing social determinants in expanding access to pain management. For IRFs, adopting opt-
out policies that prioritize conservative care empowers clinicians, accelerates response times, and
aligns treatment with patient-centered, evidence-based standards. Together, this body of
evidence provides a robust foundation for transforming pain management into a consistent,
timely, and equitable practice across rehabilitation settings.

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