Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Musculoskeletal Disorders

Abstract

Background and Objective. Musculoskeletal diseases (MSDs) are acutely or chronically painful conditions that cause limitations in mobility, dexterity, and participation in society. They are a major contributor to years lived with disability worldwide and their burden is higher in countries with a lower sociodemographic index, like the Philippines. The goal of this clinical practice guideline (CPG) is to provide recommendations to primary care providers on screening for MSDs among asymptomatic, apparently healthy children and adults.

Methods. Following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to CPG development recommended in the Department of Health Manual, the evidence of net benefit or harm of screening for nine musculoskeletal conditions and risk factors was obtained through systematic literature search. Information on cost-effectiveness, patient values and preferences, acceptability, feasibility of screening, and its impact on equity were also obtained. The final recommendations were formulated through consensus by a panel of representatives from multiple stakeholder groups.

Results. There were 15 recommendations formulated. Strong recommendations were given to screen for physical inactivity among adults, fall risks and sarcopenia for adults aged ≥60 years old, and osteoporosis among women aged ≥65 years old. However, strong recommendations were made against screening for low vitamin D among infants, children, and adults, and against screening for osteoporosis among men and among women aged <65 years old.

Conclusion. Through a comprehensive evaluation of the best available evidence using the GRADE approach, the Task Force developed 15 recommendations on screening and risk factor assessment for nine MSDs. These recommendations will serve as guidance on screening for MSDs at the primary care level.