Development and use of mobile messaging for individuals with musculoskeletal pain conditions: a scoping review (Preprint)

Abstract

Population studies show that musculoskeletal (MSK) conditions are a leading contributor to the total burden of healthy life lost, second only to cancer, and with a similar burden to cardiovascular disease; prioritising the delivery of effective treatments is needed and with the ubiquity of consumer smart devices, the use of digital health interventions is increasing. Text messaging is popular, easy to use, and has been studied for a range of health-related uses including health promotion, encouraging behaviour change, and monitoring disease progression; it may have a useful role to play in the management and self-management for people with MSK conditions.

Previous reviews of the use of messaging for people with MSK conditions have focussed on synthesising evidence of effectiveness from RCTs. In this review, our objective was to map the MSK messaging literature more broadly, to identify information which may inform the design of future messaging interventions, and to summarise the current evidence of efficacy, effectiveness, and economics.

Using a pre-published protocol developed using the Joanna Briggs Institute Manual for Evidence Synthesis, we conducted a comprehensive scoping review of the literature (2010-2022; sources PubMed, CINAHL, Embase, and PsycInfo) relating to SMS and app-based messaging for people with MSK conditions. We described our findings using tables, plots, and a narrative summary.

We identified a total of 8,328 papers for screening, of which 50 were included in this review (three previous reviews; 47 papers describing 40 primary studies). Rheumatic diseases accounted for the largest proportion of included primary studies 19/40 (47.5%), followed by studies of multiple MSK conditions or pain sites (10/40; 25%), back pain (9/40; 22.5%), neck pain (1/40; 2.5%), and ‘other’ (1/40; 2.5%). Most (33/40; 82.5%) studies described interventions intended to promote positive behaviour change, typically by encouraging increased physical activity and exercise. Studies evaluated a range of outcomes including pain, function, quality of life, and medication adherence. Overall, results either favoured messaging interventions or had equivocal outcomes. While the theoretical underpinnings of interventions were generally well described, only two papers provided comprehensive descriptions of messaging intervention design and development process. We found no economic evaluations of messaging interventions for people with MSK conditions.

Messaging has been used for the care and self-management of a range of MSK conditions with generally favourable outcomes reported. However, with few exceptions, design considerations are poorly described in the literature; further work is needed to understand and disseminate information about messaging content, and message delivery characteristics such as the timing and frequency specifically for people with MSK conditions. Similarly, further work is needed to understand the economic effects of messaging, and practical considerations relating to implementation and sustainability.

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RR2-https://doi.org/10.1136/bmjopen-2021-048964