{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:53:11Z","timestamp":1792043591687,"version":"4.4.0"},"reference-count":91,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Persistent pain is a global cause of disability, affecting daily life and physical, psychological, and social functioning. While biomedical approaches may alleviate symptoms, they often overlook psychological, behavioral, and contextual contributors. Recently, therapeutic pain education has emerged as a key non-pharmacological strategy; however, consensus on its core content and implementation is still lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective was to reach an international expert consensus on the core components of therapeutic education programs for individuals with persistent pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The study consisted of a 3-round Delphi consensus study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>An international, online Delphi modality was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Twenty-one multidisciplinary experts from 10 countries (high- to middle-income ratio: 19\/2) were included in the present study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention(s) or Exposure(s)<\/jats:title>\n                    <jats:p>Participation consisted of a structured Delphi process of 1 open-ended round and 2 structured rounds using a 4-point Likert scale, organized across 8 predefined domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome and Measure(s)<\/jats:title>\n                    <jats:p>The main outcome was expert agreement on core components of therapeutic pain education, defined as an Aiken V value \u22650.7 with their 95% confidence interval exceeding this threshold. The process was organized around 8 domains: topic areas, patient\/learner characteristics, materials and resources, activities, dosage and frequency, learning outcomes, context\/environment, and adherence assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The experts, with a mean of 20\u00a0years of clinical experience (SD\u2009=\u20099.6) and 15\u00a0years of research experience (SD\u2009=\u20096.4), reached agreement on 35 items. Experts highlighted core content such as neuroplasticity, pain-related beliefs, emotional regulation, and behavior change. They recommended assessing motivation, readiness to change, expectations, tailoring interventions to patient profiles, using explicit, evidence-based materials, including graded exposure and pacing, adjusting dosage according to engagement, ensuring a safe, welcoming, private environment, and assessing changes in beliefs, functioning, and lifestyle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides an internationally validated framework for designing and implementing therapeutic education programs for individuals with persistent pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance<\/jats:title>\n                    <jats:p>By translating expert consensus into practical components, it bridges the gap between theory and clinical practice, supporting consistent, patient-centered strategies and informing future implementation and research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ptj\/pzag029","type":"journal-article","created":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T12:31:40Z","timestamp":1774182700000},"source":"Crossref","is-referenced-by-count":2,"title":["Toward a shared framework for therapeutic pain education: a Delphi-based international consensus"],"prefix":"10.1093","volume":"106","author":[{"given":"Silvia","family":"Di-Bonaventura","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , 28922 Alcorc\u00f3n , Madrid,","place":["Spain"]},{"name":"International Doctoral School, Faculty of Health Sciences, URJC , 28933 Alcorc\u00f3n , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Gurdiel-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Departamento de 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Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferran","family":"Cuenca-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, University of Valencia , 46010 Valencia , Comunitat Valenciana,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1314-624X","authenticated-orcid":false,"given":"Josu\u00e9","family":"Fern\u00e1ndez-Carnero","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , 28922 Alcorc\u00f3n , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Grande-Alonso","sequence":"additional","affiliation":[{"name":"Departamento de Cirug\u00eda, Ciencias M\u00e9dicas y Sociales, Facultad de Medicina, Universidad de Alcal\u00e1 , 28871 Alcal\u00e1 de Henares , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2571-6967","authenticated-orcid":false,"given":"Eva","family":"Huysmans","sequence":"additional","affiliation":[{"name":"Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel , 1050 Brussels, Brussels-Capital Region,","place":["Belgium"]},{"name":"Research Foundation \u2013 Flanders (FWO), 1000 Brussels , Brussels-Capital Region,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"La Touche","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios (CSEU) La Salle, Universidad Aut\u00f3noma de Madrid , 28023 Madrid , Madrid,","place":["Spain"]},{"name":"Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, Universidad Aut\u00f3noma de Madrid , 28023 Madrid , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Montero-Cuadrado","sequence":"additional","affiliation":[{"name":"Unit for Active Coping Strategies for Pain in Primary Care, East-Valladolid Primary Care Management, Castilla and Le\u00f3n Public Healthcare System (SACYL) , 47011 Valladolid , Castilla y Le\u00f3n,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4068-9338","authenticated-orcid":false,"given":"Rodrigo","family":"Nu\u00f1ez-Cortes","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, University of Chile , 8380453 Santiago , Regi\u00f3n 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L","family":"Puentedura","sequence":"additional","affiliation":[{"name":"Doctor of Physical Therapy Program, Robbins College of Health and Human Sciences, Baylor University , Waco, TX ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe J J","family":"Reis","sequence":"additional","affiliation":[{"name":"Postgraduaste Program in Science, Technology, and Innovation in Health, Instituto Federal de Educa\u00e7\u00e3o, Ci\u00eancia e Tecnologia do Rio de Janeiro (IFRJ) , Rio de Janeiro, RJ ,","place":["Brazil"]},{"name":"School of Physical and Occupational Therapy, Faculty of Medicine, McGill University , QC H3G 1Y5 Montreal , Quebec,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1623-7681","authenticated-orcid":false,"given":"Giacomo","family":"Rossettini","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, University of Verona , 37134 Verona , 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