Original Research

Clinical recommendations for chronic musculoskeletal pain in South African primary health care

Dawn V. Ernstzen, Romy Parker, Tasleem Ras, Klaus Von Pressentin, Quinette A. Louw
African Journal of Primary Health Care & Family Medicine | Vol 15, No 1 | a3929 | DOI: https://doi.org/10.4102/phcfm.v15i1.3929 | © 2023 Dawn V. Ernstzen, Romy Parker, Tasleem Ras, Klaus Von Pressentin, Quinette A. Louw | This work is licensed under CC Attribution 4.0
Submitted: 25 November 2022 | Published: 25 April 2023

About the author(s)

Dawn V. Ernstzen, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Romy Parker, Pain Management Unit, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and Groote Schuur Hospital, Cape Town, South Africa
Tasleem Ras, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Klaus Von Pressentin, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Quinette A. Louw, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Abstract

Background: Chronic musculoskeletal pain (CMSP) is prevalent globally and places a significant burden on individuals, healthcare systems and economies. Contextually appropriate clinical practice guidelines (CPGs) on CMSP are advocated to translate evidence into practice.

Aim: This study aimed to investigate the applicability and feasibility of evidence-based CPG recommendations for adults with CMSP in the primary health care (PHC) sector of South Africa (SA).

Setting: The PHC sector in South Africa (SA).

Methods: Consensus methodology was used, comprising two online Delphi rounds and a consensus meeting. A multidisciplinary panel of local healthcare professionals involved in CMSP management was purposefully sampled and invited to participate. The first Delphi survey considered 43 recommendations. In the consensus meeting, the results of the first Delphi round were discussed. The second Delphi round reconsidered the recommendations with no consensus.

Results: Seventeen experts participated in the first Delphi round, 13 in the consensus meeting and 14 in the second Delphi round. In Delphi round two, 40 recommendations were endorsed, three were not endorsed and an additional recommendation was added.

Conclusion: A multidisciplinary panel endorsed 41 multimodal clinical recommendations as applicable and feasible for the PHC of adults with CMSP, in SA. Although certain recommendations were endorsed, they may not be readily implementable in SA because of context factors.

Contribution: The study forms the basis of a model of care for contextually relevant PHC of CMSP. Future research should explore factors that could influence the uptake of the recommendations into practice to optimise chronic pain care in SA.


Keywords

chronic musculoskeletal pain; clinical practice guidelines; consensus methods; primary health care; multidisciplinary; contextually relevant.

Sustainable Development Goal

Goal 3: Good health and well-being

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