An Evaluation of the Design of Multimedia Patient Education Materials in Musculoskeletal Health Care: Systematic Review.

The findings about design come from only 44 of the 160 trials (27.5%); the rest never supplied their materials, so the four principles the authors single out as most often missed may not hold across the wider literature. The checklist used to score the materials was developed in university teaching, not with patients, so applying it to patient education is an extrapolation the authors acknowledge. Only 5 trials measured knowledge, so the review cannot say whether these materials change what patients know. Most evidence comes from wealthy countries (85.6% of trials, and only 4 of 160 from lower middle-income countries) and from middle-aged and older adults, so it says little about younger patients or about the under-resourced settings where self-management materials may matter most. Risk of bias was rated high in two or more areas in 31 of the 160 trials (19.4%), and the outcome data were too varied to pool.

The authors declared no conflicts of interest. No funding source is stated in the paper text.

Do not read this as evidence that multimedia patient education does or does not work. Only 5 of 160 trials measured patient knowledge, and none of the trials that supplied their materials measured it, so no effect on learning or pain can be taken from this review. Do not treat the four design tips as proven either: they come from a framework built for university students and were never tested against patient learning in the studies examined here.