Background & Aims

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;[1-4] prioritising the delivery of effective treatments is needed. 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.[5,6] 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.

Methods

Using a pre-published protocol developed using the Joanna Briggs Institute Manual for Evidence Synthesis,[7,8] 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.

Results

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.

Conclusions

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.

References

1.Australian Institute of Health and Welfare (AIHW). Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018. 2021 [10/5/2023]; Available from: https://www.aihw.gov.au/reports/burden-of-disease/abds-impact-and-causes-of-illness-and-death-in-aus/summary.
2.Australian Institute of Health and Welfare (AIHW). Chronic musculoskeletal conditions. 2023; Available from: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/summary.
3.Public Health England. Musculoskeletal health: trends, risk factors and disparities in England. 2023; Available from: https://fingertips.phe.org.uk/static-reports/musculoskeletal-conditions/musculoskeletal-health-trends-risk-factors-and-disparities-in-england.html.
4.Public Health England. Data file to accompany the published report: Musculoskeletal health: trends, risk factors and disparities in England. 2023; Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1120336/Musculoskeletal_health_data.ods
5.Fritsch CG, Ferreira PH, Prior JL, McLachlan AJ, Ferreira ML. Effects of using text message interventions for the management of musculoskeletal pain: a systematic review. Pain. 2020;161(11):2462-75.
6.Hewitt S, Sephton R, Yeowell G. The effectiveness of digital health interventions in the management of musculoskeletal conditions: systematic literature review. Journal of medical Internet research. 2020;22(6):e15617.
7.Peters M, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis, JBI, 2020. Available from https://synthesismanual.jbi.global . https://doi.org/10.46658/JBIMES-20-12
8.Scotti Requena S, Sterling M, Elphinston RA, Ritchie C, Robins S, R Armfield N. Development and use of mobile messaging for individuals with musculoskeletal pain conditions: a scoping review protocol. BMJ Open. 2021;11(7):e048964. doi: 10.1136/bmjopen-2021-048964.

Presenting Author

Nigel Armfield

Poster Authors

Nigel Armfield (PhD)

PhD

RECOVER Injury Research Centre, The University of Queensland, Queensland, Australia

Lead Author

Rachel Elphinston

The University of Queensland

Lead Author

Jenna Liimatainen

Lead Author

Simone Scotti Requena

Lead Author

Chloe-Emily Eather

Lead Author

Sisira Edirippulige

Lead Author

Carrie Ritchie

Lead Author

Sarah Robins

Lead Author

Michele Sterling

RECOVER Injury Research Centre, The University of Queensland, Queensland, Australia

Lead Author

Topics

  • Access to Care