Care at a distance: Understanding lived experiences of people with MSK disorders receiving non-pharmacological interventions delivered through synchronous telehealth: A systematic rapid review

TL;DR

This study explores how people with musculoskeletal disorders experience non-drug treatments delivered via real-time telehealth, and what this means for future telehealth practices.

Contribution

The paper provides new insights into patient experiences with synchronous telehealth for MSK disorders and identifies clinical implications for its delivery.

Findings

Patient experiences with telehealth were influenced by perceptions of technology, relationships with practitioners, and the perceived importance of physical exams.

Five clinical implications were identified to guide future telehealth strategies and research in MSK disorder management.

Findings suggest that telehealth accessibility and patient-practitioner dynamics are critical to successful implementation.

Abstract

Little is known about lived experience of synchronous telehealth in patients with musculoskeletal (MSK) disorders.

We conducted a rapid systematic review to answer: (1) what are the lived experiences and/or perspectives of people with MSK disorders receiving non-pharmacological interventions delivered through synchronous telehealth; and (2) what clinical implications can be inferred from qualitative studies focusing on lived experiences for how telehealth is delivered in the management of MSK disorders?

A comprehensive search of MEDLINE, CINAHL, PsycINFO, ProQuest, and Google Scholar from June 2010 to July 2023. Eligible qualitative and mixed methods studies capturing lived experiences of adults with MSK disorders receiving non-pharmacological interventions via synchronous telehealth were included.

Systematic rapid review conducted according to WHO guidelines. Titles and abstracts screened by reviewers independently, eligible studies critically appraised, and data was extracted. Themes summarized using the Consolidated Framework for Implementation Research (CFIR). GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) used to assess confidence in synthesis findings.

We identified 9782 references, screened 8029, and critically appraised 22, and included 17 studies. There is evidence to suggest that the experience of telehealth prior to and during the pandemic was shaped by (1) patient perception of telehealth, (2) existing relationships with practitioners, (3) availability and accessibility of telehealth technologies, and (4) perceptions about the importance of the role of the physical exam in assessing and treating MSK disorders.

The five identified implications could be used to inform future research, policy, and strategy development.

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