The Burden of Informal Caregiving for Adults with Musculoskeletal Conditions: A Systematic Review

Nanati Legese Alemu (), Neha Das, Jennifer J. Watts, Suzanne Robinson, Gang Chen and Lan Gao
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Nanati Legese Alemu: Institute for Health Transformation, Deakin University
Neha Das: Institute for Health Transformation, Deakin University
Jennifer J. Watts: Institute for Health Transformation, Deakin University
Suzanne Robinson: Institute for Health Transformation, Deakin University
Gang Chen: University of Melbourne
Lan Gao: Institute for Health Transformation, Deakin University

PharmacoEconomics, 2025, vol. 43, issue 10, No 3, 1179-1204

Abstract: Abstract Background and Objective Informal caregivers play a critical role in supporting individuals with musculoskeletal conditions. This systematic review aimed to evaluate the psychological and economic burdens associated with caregiving for musculoskeletal conditions. Methods We conducted a systematic review in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, searching MEDLINE, Embase, CINAHL, EconLIT, and APA PsycINFO for studies published between 2000 and April 2025. Studies were eligible if they examined the psychological and economic burden of informal caregiving for adults with musculoskeletal conditions. Screening and data extraction were conducted using EndNote 21 and Covidence. Risk of bias was assessed using the CASP checklist for psychological burden studies and the EVERS criteria for economic burden studies. Data were synthesized narratively. An exploratory meta-analysis of informal care hours was conducted using a subset of studies with sufficient statistical data. Results A total of 41 studies were included, with 24 reporting psychological burdens, 16 economic burdens, and one for both. Caregiving burden included emotional, social, financial, and time-related impacts, impacting the caregivers’ quality of life. Higher anxiety and depression were correlated with a greater caregiver burden. Informal care costs varied by musculoskeletal condition type, location, severity, intensity, and valuation method. Reported informal care hours showed substantial variation across studies. The overall risk of bias across included studies was low. Conclusions This systematic review highlights the considerable psychological, economic, and time-related burdens faced by informal caregivers of individuals with musculoskeletal conditions. Caregivers face high stress, physical strain, and opportunity costs. The lack of standardized assessments hinders accurate burden quantification, economic evaluation, and policy responses. Future efforts should focus on adopting consistent measurement instruments and valuation methods, alongside implementing structured policies, financial support, and psychological interventions to better support the caregivers.

Date: 2025
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DOI: 10.1007/s40273-025-01523-x

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