t my own pace, space, and place: a systematic review of qualitative studies of enablers and barriers to telehealth interventions for people with chronic pai

Author(s)

Fernandes, Livia G. ^[1] ; Devan, Hemakumar ^[2] ; Fioratti, Iuri ^[1] ; Kamper, Steven J. ^{[3, 4, 5, 6]} ; Williams, Christopher M. ^{[7, 8]} ; Saragiotto, Bruno T. ^{[1, 3, 4]}

Affiliation

^[1] Univ Cidade Sao Paulo UNICID, Masters & Doctoral Programs Phys Therapy, Sao Paulo, SP - Brazil

^[2] Univ Otago, Ctr Hlth Act & Rehabil Res CHARR, Sch Physiotherapy, Wellington - New Zealand

^[3] Sydney Local Hlth Dist, Inst Musculoskeletal Hlth, Camperdown, NSW - Australia

^[4] Univ Sydney, Camperdown, NSW - Australia

^[5] Univ Sydney, Fac Med & Hlth, Sch Hlth Sci, Sydney, NSW - Australia

^[6] Nepean Hosp, Nepean Blue Mt Local Hlth Dist, Penrith, NSW - Australia

^[7] Hunter New England Local Hlth Dist, Hunter New England Populat Hlth, Wallsend - Australia

^[8] Univ Newcastle, Sch Med & Publ Hlth, Hunter Med Res Inst, Newcastle, NSW - Australia

• Document type: Review article
• Source: Pain; v. 163, n. 2, p. E165-E181, FEB 2022.
• Web of Science Citations: 2

Abstract

Telehealth is a promising approach to support self-management with the potential to overcome geographical barriers. Understanding patient perspectives will identify practical challenges to delivering self-management strategies by telehealth. The aim of this study was to synthesize the perceptions of people with chronic musculoskeletal pain for engaging in interventions delivered using telehealth. We searched MEDLINE, Embase, CINAHL, LILACS, and PsycINFO databases. We included qualitative studies that explored perceptions or experiences or attitudes of people with chronic musculoskeletal pain engaging with telehealth. We assessed the methodological quality using the Critical Appraisal Skills Programme checklist. Meta-synthesis was guided by a thematic synthesis approach. The level of confidence of review findings was assessed using the Confidence in the Evidence from Reviews of Qualitative Studies (GRADE-CERQual). Twenty-one studies were included (n = 429). Telehealth comprised web-based, videoconference-based, telephone-based, video-based, and smartphone app-based programs delivered solely or combined. Chronic musculoskeletal conditions included people with knee or hip osteoarthritis, chronic low back pain, persistent pain (chronic joint pain or nonspecific chronic musculoskeletal pain), rheumatoid arthritis, and functional fatigue syndrome. The enablers for engaging in telehealth interventions were as follows: (1) ``at my own pace, space, and place{''} and (2) empowered patient. Barriers to engaging in telehealth interventions were as follows: (1) impersonal, (2) technological challenges, (3) irrelevant content, and (4) limited digital (health) literacy. Telehealth interventions with well-designed interactive platforms, flexibility to fit patients' routine, and the broad availability of material may favor better engagement. Encouragement of self-efficacy is linked to successful telehealth-delivered self-management programs. (AU)

• FAPESP's process: 16/24217-7 - The effectiveness of a telerehabilitation program for chronic musculoskeletal pain: the e-Rehab program
• Grantee: Bruno Tirotti Saragiotto
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 19/14032-8 - Enablers and barriers of people with chronic pain for engaging in remote-delivered intervention programs
• Grantee: Lívia Gaspar Fernandes
• Support Opportunities: Scholarships in Brazil - Master