Scoping review of equity considerations in digitally enabled patient education interventions for self-managing chronic musculoskeletal pain

Abstract

Patient education is critically important for supporting self-management of chronic musculoskeletal pain, but it is unclear if and how existing tools or interventions are meeting diverse pain management needs. Therefore, this review aimed to identify and characterise digitally enabled pain education tools or interventions and explore the extent to which they meet diverse needs. We searched five electronic databases, including MEDLINE (via Ovid; Annexure A ), Embase (via Ovid), CINAHL, PsycInfo and Google Scholar in January 2025, and screened articles based on pre-defined eligibility criteria. Articles were eligible if they reported on the development, evaluation and use of digitally enabled pain education tools or interventions, supporting pain self-management. Data was extracted and analysed descriptively. Our search strategy yielded 12,545 search results, out of which 100 studies were included. Majority of these studies were published in North America and Europe ( n  = 86; 86%) and lacked focus on population subgroups having higher pain management needs ( n  = 86; 86%). Out of 39 named or unique interventions, 13 tools or interventions were tailored to meet diverse needs. Most of the studies ( n  = 81; 81%) reported the results of real-world testing and effectiveness evaluation. There were only few studies reporting on the early development stages (i.e., co-design studies and prototype testing). For effectiveness studies, pain intensity, pain interference, pain-related knowledge, self-efficacy, function, opioid use and quality of life were commonly measured patient-reported outcomes. Although there are several digitally enabled patient education tools or interventions to support pain self-management, fewer are available to address the diverse needs. Therefore, future research and development should focus on understanding and addressing these unmet needs for developing more inclusive and equitable digitally enabled patient education interventions.