ONE STEP AT A TIME. SHAPING CONSENSUS ON TERMINOLOGY AND RESEARCH PRIORITIES IN TELEHEALTH IN MUSCULOSKELETAL PAIN: A DELPHI STUDY

J. Fandim¹, R. Hinman², C. Øverås^3,4, S. Sharma^5,6,7, J. Belton⁸, V. Oliveira⁹, B. Dear¹⁰, R. Parker¹¹, B. Ghai¹², K. Bennell¹³, P. Ferreira¹⁴, J. Hartvigsen^3,15, B. Saragiotto¹

¹Universidade Cidade de São Paulo, Masters and Doctoral Program in Physical Therapy, São Paulo, Brazil, ²University of Melbourne, Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, Melbourne, Australia, ³University of Southern Denmark, Department of Sports Science and Clinical Biomechanics, Denmark, Denmark, ⁴Norwegian University of Science and Technology, Department of Public Health and Nursing, -, Norway, ⁵University of New South Wales, School of Health Sciences, Faculty of Medicine, Sydney, Australia, ⁶Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia, ⁷Kathmandu University School of Medical Sciences, Department of Physiotherapy, Dhulikhel, Nepal, ⁸IASP Global Alliance of Partners for Pain Advocacy (GAPPA), -, United States, ⁹Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Postgraduate Program in Rehabilitation and Functional Performance, Diamantina, Brazil, ¹⁰Macquarie University, School of Psychological Sciences, Sydney, Australia, ¹¹University of Cape Town, -, South Africa, ¹²Post Graduate Institute of Medical Education and Research, Department of Anaesthesia and Intensive Care, Chandigarh, India, ¹³University of Melbourne, Centre for Health, Exercise & Sports Medicine, Department of Physiotherapy, Australia, Australia, ¹⁴University of Sydney, Sydney, Australia, ¹⁵Chiropractic Knowledge Hub, Odense, Denmark

Background: Telehealth has provided healthcare services to patients over the past decades and its use has grown substantially during the COVID-19 outbreak. Evidence demonstrates heterogeneity in the telehealth terminology between interested parties and a lack of agenda for research priorities in telehealth in musculoskeletal pain research.

Purpose: This international modified three-round e-Delphi survey has two folded purposes. Consensus on standardization of terminology to be used in telehealth among all interested parties in musculoskeletal pain. Establish research priorities for the practice of musculoskeletal pain telehealth.

Methods: We invited researchers thought leaders, clinicians, consumer representatives, industry partners and developers, healthcare managers, and policymakers identified via Expertscape, PubMed database and social media. We also used a snowball sampling strategy to recruit other potential participants. The survey was sent by email with a link to the Typeform® platform. A list of potential terminologies and research priorities based on previously published studies with adjustments through the research group and International Steering Committee was presented to panel members’ participants. Panel members selected different telehealth terminologies for musculoskeletal pain research known. Subsequently, panel members were asked to rate the level of agreement of each terminology for "telehealth" to be used in musculoskeletal pain research and the research priorities for the "telehealth in musculoskeletal pain research" field. A 5-point Likert scale was used to rate the level of agreement of each item and a priori cut-off points of at least 80% were used to establish consensus in each round. Descriptive analysis of the results was performed using measures of central tendency (SD), and absolute and relative frequencies.

Results: We invited 694 potential participants, which 160-panel members participated in the first round, 133 in the second round, and 134 in the third round. The panel members’ response rate for the second round was 83.1% and for the third was 83.7%. Most panel members were researchers 47.5%, clinicians 35.6% and consumers representatives 5.6%, mean age 41.6 (10.9), who lived in Brazil 19.4%, India 13.8%, and Australia 11.9%, 60% from high-income economies. Panel members reached a consensus on two terminologies and 14 research priorities from an initial list of 37 terminologies and 19 research priorities over the three rounds. Panel members reached a consensus for digital health and telehealth as standard terminologies and 14 research priorities considering featuring topics such as study designs, treatment effectiveness and implementation, education, health literacy and health equity for musculoskeletal pain research.

Conclusions: Allinterested parties reached a consensus that the digital health and telehealth term may be the most common and possibly standardized terminologies to be used among the community for the moment. Interested parties identified a set of 14 telehealth musculoskeletal pain research priorities worldwide focused on the community's critical healthcare needs.

Implications: Consensus on terminology will facilitate clear and unmisleading communication about the use of communication and information technology in healthcare for people with musculoskeletal disorders. A set of research priorities based on the needs of all interested parties worldwide allows a research agenda to be developed and achieved for the upcoming future.

Funding acknowledgements: Partially funded by Coordination for the Improvement of Higher Education Personnel (CAPES) and São Paulo Research Foundation (FAPESP) (nº 2021/05477-6).

Keywords:
Telehealth
Research priorities
Musculoskeletal pain

Topics:
Musculoskeletal
Pain & pain management
Globalisation: health systems, policies & strategies

Did this work require ethics approval? Yes

Institution: Universidade da Cidade de São Paulo

Committee: Research Ethics Committee

Ethics number: 40705620.5.0000.0064