This systematic review assessed whether real-time telehealth interventions reduce pain intensity and disability in people with osteoarthritis of the knee and hip or spinal (back or neck) pain compared to usual care or face-to-face interventions. Types of telehealth interventions included interventions delivered remotely by any person (i.e., therapist, health professional or trained operator) by telephone or videoconferencing in which there was a direct person-to-person verbal exchange of information. The primary outcomes were pain intensity and disability. Risk of bias was assessed with the Cochrane risk of bias tool. The quality of the evidence was evaluated using the GRADE approach. In total, 15 randomised controlled trials were included in the meta-analyses (n=2789 participants). Meta-analysis of data from five studies (n=1357 participants) revealed moderate quality evidence of a small intervention effect of telephone-based interventions with educational materials on pain intensity when compared to usual care (standardised mean difference -0.27, 95% CI -0.53 to -0.01). Positive effects were found for spinal pain (standardised mean difference -0.55, 95% CI -0.92 to -0.19) but not for osteoarthritis. Meta-analysis of seven studies (n=1537 participants) revealed moderate quality evidence of a small effect of telephone-based interventions with educational materials on disability when compared to usual care (standardised mean difference -0.21, 95% CI -0.40 to -0.02). Again, positive effects were found for spinal pain (standardised mean difference -0.64, 95% CI -1.01 to -0.27), but not for osteoarthritis. There was moderate quality evidence that telephone intervention plus face-to-face intervention did not improve pain or disability compared to usual care or face-to-face intervention alone. Telephone-based services offer the potential to support people with spinal or osteoarthritis pain to access better quality care.
O’Brien KM et al. Effectiveness of telephone-based interventions for managing osteoarthritis and spinal pain: a systematic review and meta-analysis. PeerJ 2018;6:e5846