{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T16:27:00Z","timestamp":1776702420778,"version":"3.51.2"},"reference-count":61,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T00:00:00Z","timestamp":1581638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic musculoskeletal pain is a major health concern. The biopsychosocial approach is an evidence\u2010based approach recommended for managing chronic musculoskeletal pain. However, the evidence for this approach is largely reported from high\u2010income countries; therefore, it is important to ascertain how biopsychosocial approaches are operationalised in low\u2010 and middle\u2010income countries to inform practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To examine the evidence for the operationalization of biopsychosocial interventions in managing patients with chronic musculoskeletal pain in low\u2010and middle\u2010income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The search included studies published in English from 2008 to September 2019 in: Cochrane library, OVID, CINAHL, Scopus, PUBMED, Web of Science, and SportDiscus. Randomised and non\u2010randomised trials using a biopsychosocial intervention were considered. The review team developed a search strategy; two independent reviewers screened and assessed results for quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen studies were included (<jats:italic>n<\/jats:italic> = 996) with mainly low back pain populations (<jats:italic>n<\/jats:italic> = 11 studies). Others were osteoarthritis (n = 1) and other musculoskeletal pain (<jats:italic>n<\/jats:italic> = 4). The majority (<jats:italic>n<\/jats:italic> = 12) of studies attained fair to poor quality, three had good quality, one scored excellent quality. Interventions applied biopsychosocial principles such as cognitive functional therapy, and graded activity, delivered by healthcare professionals such as physiotherapists and doctors. However, most results provided insufficient information regarding healthcare professionals' capacity to deliver interventions, lack of information regarding intervention delivery and training of healthcare professionals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results highlight the potential for delivering biopsychosocial interventions in low\u2010 and middle\u2010income countries; however, future research should consider robust methodological approaches with clear details to achieve high\u2010quality trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/msc.1462","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T08:40:27Z","timestamp":1581669627000},"page":"227-244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Operationalisation of a biopsychosocial approach for the non\u2010pharmacological management of patients with chronic musculoskeletal pain in low\u2010 and middle\u2010income countries: A systematic review"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9219-9154","authenticated-orcid":false,"given":"Paapa Kwesi","family":"Ampiah","sequence":"first","affiliation":[{"name":"Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences University of Nottingham  Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Hendrick","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences University of Nottingham  Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Moffatt","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences University of Nottingham  Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1752-2027","authenticated-orcid":false,"given":"Josephine","family":"Ahenkorah","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy and Rehabilitation Sciences, School of Health Sciences University of Nottingham  Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,14]]},"reference":[{"issue":"37","key":"e_1_2_9_2_1","first-page":"1","article-title":"Barriers for conducting clinical trials in developing countries\u2010 a systematic review","volume":"17","author":"Alemayehu C.","year":"2018","journal-title":"International Journal for Equity in Health"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ft.2018.07.002"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"issue":"8","key":"e_1_2_9_5_1","first-page":"273","article-title":"Effectiveness of attentional bias modification and cognitive behavioral therapy on the reduction of pain intensity in patients with chronic pain","volume":"5","author":"Babai F.","year":"2016","journal-title":"International Journal of Medical Research and Health Sciences"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4314\/gmj.v49i3.8"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-282X2012001100008"},{"key":"e_1_2_9_8_1","first-page":"979","article-title":"Developing and evaluating complex interventions: the new Medical Research Council guidance","volume":"337","author":"Craig P.","year":"2008","journal-title":"BMJ"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqm036"},{"issue":"3","key":"e_1_2_9_10_1","first-page":"16","article-title":"Report of the NIH task force on research standards for chronic low back pain","volume":"8","author":"Deyo R. 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