Challenges and Perspectives in Treating Individuals With Musculoskeletal Disorders and Comorbidity: A Systematic Literature Review With a Descriptive Thematic Synthesis.
Laura Celine Rømer, Jacob S Gandløse, Jane Andreasen and 2 others
PMID 41044907WHAT IT FOUND
Physiotherapists and occupational therapists caring for people with musculoskeletal disorders plus diabetes, obesity or mental health problems said they lacked training to address comorbidities.
They also faced limited allied health sessions, scope uncertainty and guilt about ignoring other conditions.
Key findings
01Clinicians described a lack of knowledge and training for managing comorbidities such as diabetes and mental health problems alongside musculoskeletal care.
02Limited allied health sessions and uncertainty about how to incorporate comorbidities made some clinicians feel they could not address them fully.
03Some clinicians reported guilt or helplessness when they felt unable to address obesity and other comorbidities.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review included only five qualitative studies, so the themes may not represent all clinicians or settings. Most included studies focused on osteoarthritis and a limited range of comorbidities, so it may not apply to all musculoskeletal disorders. The included studies reported experiences among physiotherapists and occupational therapists only, not nurses, physicians or psychologists. The studies investigated a single comorbidity alongside the musculoskeletal disorder, not multiple distinct chronic illnesses at the same time. The authors note that subjectivity in thematic synthesis and study heterogeneity may have shaped the themes. The review synthesised experiences, not patient outcomes or treatment effectiveness.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that integrated comorbidity care improves musculoskeletal outcomes. This review reports clinicians' perceived barriers and experiences, not tested interventions or patient results.