Stefan Elbers

227 Summary control condition would only receive the standard IMPT treatment. We were to evaluate the difference in longitudinal outcomes of pain-related disability between both groups. In addition, we were to evaluate the effect of the AGRIPPA app on health care utilization and societal costs and explore to what extent usability measures are associated with a favourable change over time of pain-related disability. This study was intended to provide insight into the question of to what extent the app would influence the maintenance of treatment gains over time. Chapter 8 contains a general discussion on the findings of this research project. With respect to clinical practice, we first stress the potential of integrating behaviour change strategies into rehabilitation programmes. Based on the two systematic reviews, we also highlight the importance of detailed intervention descriptions. Recently, multiple classification systems have become available which can guide clinicians and researchers in providing a concise overview of rehabilitation programmes, including a clear description of active ingredients, dosing parameters and tailoring options. This could help to make sense of the heterogeneity in interventions and outcomes of IMPT programmes. We next discuss the increased importance of digital applications in rehabilitation, and recommend the critical evaluation of the implementation process to ensure sufficient adaptation for all patient groups. Implications for research include further suggestions to extend the scope of the living systematic review project, for example by including additional analyses and outcomes.We further discuss the development of self-management interventions that have become available since the publication of our systematic review. With respect to co-design, we reflect on both its democratic and technocratic value in the context of intervention development projects. The concluding paragraph provides three directions for future impact: further development and dissemination of the AGRIPPA application; integration of behaviour change principles into clinical reasoning approaches; and the potential of interdisciplinary public consortia on translating research findings to clinical practice.