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At my own pace, space, and place: a systematic review of qualitative studies of enablers and barriers to telehealth interventions for people with chronic pain
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.
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“VCT-PMP improves accessibility and comfort for some (caring responsibilities, cost of and/or ability to travel, reduced time pressures, health problems, anxiety), 22 but not others (digital poverty and/or illiteracy, conditions making use of screens dif fi cult or impossible). 23”
From A service evaluation to examine the effectiveness of chronic pain management programmes delivered using video conferencing technology compared to in-person (2023) · cites this paper as [23]
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Metadata
- Authors
- Fernandes, L. G., Devan, H., Fioratti, I., Kamper, S. J., Williams, C. M., & Saragiotto, B. T.
- Affiliations
- Universidade Cidade de São Paulo (BR)
- University of Otago (NZ)
- The University of Sydney (AU)
- Hunter Medical Research Institute (AU)
- Corresponding author
- Fernandes, Lívia G.
- ORCID
- Venue
- Pain
- Published
- 2021-06-14
- Volume
- 163
- Issue
- 2
- Pages
- e165-e181
- ISSN
- 0304-3959 (ISSN-L)
- 1872-6623
- OpenAlex
- W3177245897
- Cited by
- 118
- References
- 85
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 36 · 2023: 25 · 2022: 18 · 2021: 4
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- telemedicine, chronic musculoskeletal pain, self-management, patient engagement, barriers and facilitators, patient perspectives, digital health literacy, technical challenges, osteoarthritis, chronic low back pain, rheumatoid arthritis, chronic pain, fatigue syndrome, self-efficacy, mobile application
- MeSH terms
- Self-Management, Humans, Telemedicine, Qualitative Research, Chronic Pain, Musculoskeletal Pain
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