Economic evaluations of digital health interventions for the management of musculoskeletal disorders: a systematic review and meta-analysis (Preprint)

Abstract

Musculoskeletal disorders (MSDs), representing an array of inflammatory and degenerative conditions affecting the muscles, ligaments, joints, tendons, peripheral nerves, and supporting blood vessels are widespread in many countries. The huge burden of MSDs have necessitated innovative approaches such as digital health interventions, however, no study has evaluated the findings of cost-effectiveness of these interventions.

This study was aimed to synthesise the cost-effectiveness of digital health interventions for people with MSDs

Electronic databases including Medline, AMED, CIHAHL, PsycINFO, Scopus, Web of Science, and Centre for Review and Dissemination were searched for cost-effectiveness of digital health published between inception to June 2022 following the PRISMA guideline. References of all retrieved articles were checked for relevant studies. The quality appraisal of the included studies was done using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results were presented using a narrative synthesis and random effects meta-analysis.

Ten studies from six countries met the inclusion criteria. The average percent of CHEERS checklist items reported was 70.4%. Included studies were on non-specific chronic low back pain (n = 4), chronic pain (n = 2), knee and hip osteoarthritis (n = 3) and Fibromyalgia (n = 1). The economic perspectives adopted in the included studies were societal (n = 4), societal and healthcare (n = 3) and healthcare (n = 3). Of the ten included studies 5 (50%) of them used quality-adjusted life years as the outcome measures. Except one study, all the included studies reported that digital health interventions were cost effective compared to the control group. In a random effects meta-analysis (n = 2), the pooled disability and QALY were (-0.176 95% CI -0.317 to -0.035, p = 0.014) and (3.855 95% CI 2.023 to 5.687, p < 0. 001), respectively. The meta-analysis (n = 2) for the costs were in favour of the digital health intervention compared to control (-$417.52 95% CI -522.01 to – 313.03).

Studies indicate that digital health interventions are cost-effective for people with MSDs. The findings suggest that digital health intervention could help improve access to treatment for patients with MSDs and as a result improving their health outcomes. Clinicians and policy makers should consider the use of these interventions for patients with MSDs.