Effectiveness of Tailored Self-Management Interventions for People with Chronic Musculoskeletal Conditions: a Systematic Review and Meta-Analysis

Abstract

Purpose: To evaluate the effectiveness of tailored self-management interventions to improve health and behavioural outcomes for individuals living with chronic musculoskeletal (MSK) conditions. Methods: We searched relevant databases and grey literature on January 27, 2022 (CRD42022297624). We included English language randomized controlled trials and quasi-experimental trials that assessed the effect of tailored self-management on health and behavioural outcomes for individuals living with chronic MSK conditions. Eligible studies included: Individually prescribed components based on subjective and/or objective assessments; usual care or non-tailored controls; ≥1 health and behavioural outcome(s). Methodological quality was evaluated using the Cochrane Risk of Bias (RoB 2) tool and certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation. Results: Our search yielded 1558 articles, and 21 studies were included in the review. Compared with usual care/non-tailored controls, positive effects were detected in favour of tailored interventions for pain (standardized mean difference [SMD] = 0.35; 95% CI: 0.20, 0.50; moderate certainty) and quality of life, SF-12/36, (SMD = 0.22; 95% CI: 0.08, 0.37; high certainty) in people with inflammatory arthritis (IA) and chronic pain conditions. Similar effects were detected for pain self-efficacy (SMD = 0.40; 95% CI: 0.20, 0.62; moderate certainty) and quality of life, index score (SMD = 0.19; 95% CI: 0.00, 0.38; moderate certainty) across chronic MSK conditions. Conclusion: Tailored self-management interventions offer modest benefits for select health outcomes; however, clinical significance remains unclear.