Exploring the digital landscape: A scoping review of Achilles tendinopathy education on public websites and in randomised controlled trials.

Objectives: The aims of this scoping review were to (i) map education from randomised controlled trials and public websites for Achilles tendinopathy to pre-defined categories and (ii) appraise the quality of education available. Data sources: Sources were extracted via a search of multiple databases and from the first three pages of targeted Google searches in English, Chinese, and Spanish (websites). Review methods: The frequency of sources that reported on each pre-defined category (n = 15) was reported, and the content within each category was summarised descriptively. Quality and reliability were assessed with the DISCERN tool (1-5 points, higher score means higher quality and trustworthiness). Understandability and actionability of education was assessed using Patient Education Materials Assessment tool (0-100%, higher scores indicate more comprehensible information with clearer messages and more identifiable actions). Alignment with current international guidelines was reported. Results: 119 randomised controlled trials and 385 websites were included. Education coverage was better in websites compared to trials, particularly related to pathology and management. Conflicting advice was found on websites (e.g. when treatment should be sought). Quality (1.6 ± 0.5) and reliability (2.1 ± 0.7) of education were poor, with low scores for treatment risks and shared decision-making. Understandability was moderate (59%) and actionability was poor (28%). Alignment with clinical guidelines was low, with key information commonly omitted. Conclusion: Educational sources found in randomised controlled trials and public websites on Achilles tendinopathy are poorly aligned with clinical guidelines. The information gaps in these sources mean that they are unhelpful to patients and may steer them towards inappropriate decisions. The review highlights the need for the development of accurate, meaningful, and evidence-based educational resources for individuals with Achilles tendinopathy.