The effectiveness of virtual interventions targeting mental health in people with chronic musculoskeletal pain: A Systematic Review and Network Meta-Analysis
Chronic pain in muscles and joints combined with symptoms like anxiety or depression can result from a disease or traumatic injury that does not resolve. Treatments that focus only on the physical or mental health aspects of the problem typically do not work. Treatment approaches that include improving mobility and activity while addressing mental health symptoms have been shown to improve function and quality of life. These treatments are typically provided by multidisciplinary teams using intensive face-to-face outpatient or inpatient services. Lack of system capacity or restrictions placed on non-emergency services during a pandemic can prevent patients living with these disabling problems from getting the treatment they need. This review will summarize studies that tested virtual services such as telemedicine or web-based services to see if they help manage mental health symptoms, mobility, and quality of life in people with persistent musculoskeletal pain and mental health symptoms. We will describe what mechanisms might be driving treatment benefits and describe the type of interventions and platforms that can be used. This information will be combined with patients’ treatment preferences and surveys of what strategies were used during the COVID‑19 pandemic to map treatment alternatives. Statistical analyses will be used to compare many different types of treatments, to find out which treatments work best. We will compare virtual treatment to no treatment and in-person treatment. We will evaluate how treatments needs and outcomes might differ for men and women. We will use patient preferences, practice surveys, and research findings to make recommendations for better future care during a pandemic.