title: The prevalence, impact and management of musculoskeletal disorders in older people living in care homes: a systematic review.
abstract: The aim was to systematically review the literature describing the prevalence, impact and current management of musculoskeletal pain in older people living in care homes. Published literature (AMED, CINAHL, EMBASE, psycINFO, MEDLINE, Cochrane Library) and unpublished literature (OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials, UK National Research Register Archive) were searched on 1 March 2015. All studies assessing the prevalence, impact and management of musculoskeletal disorders in older people living in care homes were included. Literature was appraised using the CASP cohort and qualitative critical appraisal tools. Data were analysed using descriptive statistical approaches, meta-analysis and meta-ethnography techniques. Twenty-four papers reporting the results of 263,775 care home residents in 12 countries were identified. The evidence base was moderate in quality. Prevalence of musculoskeletal pain for people in care homes was 30.2 % (95 % confidence intervals 29.9-30.5 %; n = 105,463). Care home residents reported that musculoskeletal pain had a significant impact on their perceived independence and overall ability to participate in everyday activities of daily living. Three papers which presented data on interventions demonstrated that whilst multi-component assessment and management packages did not significantly change clinical outcomes, these empowered care home staff to feel more confident in managing these patients. Musculoskeletal pain is a common problem in care homes worldwide, and residents report significant impact on their lives. However, there is uncertainty regarding how to assess and manage such pain. PROSPERO Registration Number: CRD42014009824.
authors.affiliation: Faculty of Medicine and Health Sciences, Norwich Research Park, University of East Anglia, Queen's Building, Norwich, NR4 7TJ, UK. toby.smith@uea.ac.uk.
authors.forename: Toby O
authors.initials: TO
authors.lastname: Smith
authors.affiliation: West Suffolk Hospital, Bury St Edmunds, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Purdy
authors.affiliation: St George's Hospital, London, UK.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Latham
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Kingsbury
authors.affiliation: Emeritus Professor of Elderly Medicines, St James' University Hospital, Leeds, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Mulley
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D017281:Cost of Illness; D019468:Disease Management; D006707:Homes for the Aged; D006801:Humans; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000628:therapy*; D009735:Nursing Homes; D015995:Prevalence
keywords: Elderly; Nursing home; Pain; Prevalence; Residential home; Treatment