Group and individual telehealth for chronic musculoskeletal pain: A scoping review.

Abstract

BACKGROUND CONTEXT\nMusculoskeletal (MSK) pain presents a global challenge. Individual and group pain management programmes (PMPs) are recommended approaches for patients with chronic MSK disorders. With advances in remote healthcare capability, telehealth, and the recent COVID-19 pandemic, the importance of telehealth PMPs has become even more evident. Nevertheless, it is not known how\xa0patients perceive PMPs for their MSK complaint when delivered via telehealth.\n\n\nOBJECTIVE\nTo synthesise the evidence of patients experiences of group and individual telehealth PMPs for chronic MSK pain.\n\n\nDESIGN\nA scoping review informed by the PRISMA extension for scoping reviews.\n\n\nDATA SOURCES\nBased on a planned search strategy, modified following initial searches, an electronic search was conducted of key databases: Cochrane Library, Medline, CINAHL, EMBASE, AMED, SportDiscus and APA PsychInfo from 2010 until 11 May 2021.\n\n\nSTUDY SELECTION\nAny qualitative or mixed methods study reporting patient experiences of telehealth PMPs for patients with MSK disorders.\n\n\nDATA EXTRACTION AND DATA SYNTHESIS\nData were extracted and synthesised using thematic analysis.\n\n\nRESULTS\nFrom 446 identified studies, 10 were included. Just two studies investigated group telehealth PMPs for patients with MSK disorders, with eight delivered individually. Four main themes emerged: (1) Usability of the technology, (2) Tailored care, (3) Therapeutic alliance and (4) Managing behaviour. The findings highlight patient acceptability of telehealth to support self-management for chronic MSK disorders, with appropriate clinical and technical support. Group telehealth has the potential to empower patients with peer support. Remote delivery of PMPs also impacts on how patients and providers interact, communicate and develop a therapeutic relationship.\n\n\nCONCLUSIONS AND IMPLICATIONS\nBarriers and enablers to engagement in telehealth PMPs for patients with chronic MSK disorders have been identified. Peer support and group cohesiveness can be achieved remotely to enhance the patient experience. There is a critical need for further research in this area.