Barriers and facilitators experienced by osteopaths in implementing a biopsychosocial (BPS) framework of care when managing people with musculoskeletal pain – A mixed methods systematic review protocol

Background: Musculoskeletal (MSK) pain conditions have a substantial influence on the quality of life. Psychosocial factors such as depression, anxiety and social isolation have been shown to play an important role in the development and management of MSK pain. Therefore, clinical practice guidelines commonly recommend adopting a biopsychosocial (BPS) framework by practitioners managing MSK pain. However, it remains unclear how osteopaths implement a BPS framework in the management of MSK pain. This protocol describes the objective and methods of a systematic review of barriers and facilitators experienced by osteopaths in implementing a BPS framework of care when managing people with MSK pain. Methods: The following electronic databases from January 2005 to March 2019 will be searched: PubMed, AMED, EMBASE, CINAHL, Cochrane Library, Physiotherapy Evidence Database (PEDro), and SCOPUS. Two independent reviewers will review the title, abstract and full-text article retrieved from the databases to assess potentially eligible studies. Any studies (quantitative, qualitative and mixed methods) that investigated the use or application of the biopsychosocial approach in osteopathic practice will be included in the review. Data synthesis for qualitative studies will be done using the GRADE‐CERQual tool. Data synthesis methods for mixed method studies will be decided after data extraction and assessment. Discussion: This systematic review will provide critical insights into the barriers and facilitators experienced by osteopaths to implement the BPS framework in their practice. This may be important and timely as a BPS framework has been recommended by various clinical practice guidelines. © 2020 Elsevier Lt