Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review
Abstract Background Low-value care refers to the provision of health services that confer little or no benefit to patients, or have the potential to incur unwarranted harms. A breadth of literature exists investigating geographical variations in rates of potential low-value interventions for musculo...
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BMC
2025-01-01
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| Online Access: | https://doi.org/10.1186/s12913-024-12132-3 |
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| author | Kara Harris Alejandra Lopera-Escobar Georgina Luscombe Paulo Ferreira Carlos Mesa-Castrillon |
| author_facet | Kara Harris Alejandra Lopera-Escobar Georgina Luscombe Paulo Ferreira Carlos Mesa-Castrillon |
| author_sort | Kara Harris |
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| description | Abstract Background Low-value care refers to the provision of health services that confer little or no benefit to patients, or have the potential to incur unwarranted harms. A breadth of literature exists investigating geographical variations in rates of potential low-value interventions for musculoskeletal pain. This scoping review aimed to examine the provision of low-value care for osteoarthritis and lower back pain by degree of rurality (e.g., urban, rural and remote areas). Methods This scoping review followed the Joanna Briggs Institute (JBI) methodology. Electronic searches were performed on five literature databases with no time frame, language or terminology restrictions. Two independent reviewers screened titles and abstracts, reviewed full papers and extracted data from selected studies using a COVIDENCE-developed data extraction tool. Results After screening, 21 papers were selected. Two of the papers explicitly referenced low-value care while 19 investigated the provision of potential low-value interventions. Hip and knee arthroplasty, knee arthroscopy, inappropriate pharmacotherapy and complementary and alternative medicine, were more common in rural compared to urban areas. Hip and knee arthroplasty (in women), lumbar spinal fusion, spinal imaging and glucosamine use, were less common in remote compared to regional and urban areas. Conclusions There is a higher report of multiple low-value interventions for osteoarthritis and lower back pain in rural compared to urban areas and lower reporting in remote areas. The lack of healthcare services in rural areas may promote low-value care, while geographical isolation in remote areas may limit utilization of both low- and high-value interventions. |
| format | Article |
| id | doaj-art-1492d11ccd2441b2b134e8aaa8a1a1e8 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Health Services Research |
| spelling | doaj-art-1492d11ccd2441b2b134e8aaa8a1a1e82025-01-19T12:15:02ZengBMCBMC Health Services Research1472-69632025-01-012511910.1186/s12913-024-12132-3Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping reviewKara Harris0Alejandra Lopera-Escobar1Georgina Luscombe2Paulo Ferreira3Carlos Mesa-Castrillon4The University of Sydney, Faculty of Medicine and Health, School of Rural HealthFacultad de Fisioterapia, Universidad CESThe University of Sydney, Faculty of Medicine and Health, School of Rural HealthThe University of Sydney, Faculty of Medicine and Health, Musculoskeletal HealthThe University of Sydney, Faculty of Medicine and Health, School of Rural HealthAbstract Background Low-value care refers to the provision of health services that confer little or no benefit to patients, or have the potential to incur unwarranted harms. A breadth of literature exists investigating geographical variations in rates of potential low-value interventions for musculoskeletal pain. This scoping review aimed to examine the provision of low-value care for osteoarthritis and lower back pain by degree of rurality (e.g., urban, rural and remote areas). Methods This scoping review followed the Joanna Briggs Institute (JBI) methodology. Electronic searches were performed on five literature databases with no time frame, language or terminology restrictions. Two independent reviewers screened titles and abstracts, reviewed full papers and extracted data from selected studies using a COVIDENCE-developed data extraction tool. Results After screening, 21 papers were selected. Two of the papers explicitly referenced low-value care while 19 investigated the provision of potential low-value interventions. Hip and knee arthroplasty, knee arthroscopy, inappropriate pharmacotherapy and complementary and alternative medicine, were more common in rural compared to urban areas. Hip and knee arthroplasty (in women), lumbar spinal fusion, spinal imaging and glucosamine use, were less common in remote compared to regional and urban areas. Conclusions There is a higher report of multiple low-value interventions for osteoarthritis and lower back pain in rural compared to urban areas and lower reporting in remote areas. The lack of healthcare services in rural areas may promote low-value care, while geographical isolation in remote areas may limit utilization of both low- and high-value interventions.https://doi.org/10.1186/s12913-024-12132-3Low-value careInappropriate careMusculoskeletal painRural health servicesBack painKnee osteoarthritis |
| spellingShingle | Kara Harris Alejandra Lopera-Escobar Georgina Luscombe Paulo Ferreira Carlos Mesa-Castrillon Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review BMC Health Services Research Low-value care Inappropriate care Musculoskeletal pain Rural health services Back pain Knee osteoarthritis |
| title | Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review |
| title_full | Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review |
| title_fullStr | Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review |
| title_full_unstemmed | Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review |
| title_short | Is low-value care for persistent musculoskeletal pain more common in rural than urban areas? A scoping review |
| title_sort | is low value care for persistent musculoskeletal pain more common in rural than urban areas a scoping review |
| topic | Low-value care Inappropriate care Musculoskeletal pain Rural health services Back pain Knee osteoarthritis |
| url | https://doi.org/10.1186/s12913-024-12132-3 |
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