PONE-D-24-12823HEALTHCARE PROVIDERS’ PAIN MANAGEMENT PRACTICE AND ITS ASSOCIATED FACTORS IN ETHIOPIA. SYSTEMATIC REVIEW AND META- ANALYSISPLOS ONE

Dear Dr. Mekonnen,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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We look forward to receiving your revised manuscript.

Kind regards,

Dereje Zewdu Assefa, BSc, MSc

Academic Editor

PLOS ONE

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Additional Editor Comments:

"The manuscript needs thorough language editing and proofreading." Please remember to add the search strategy as a supplementary file and provide details of the electronic database used, along with the corresponding article numbers found in each database.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Comments for the author

Dear PLoS ONE team of editorials

Thank you for the chance given to me to review a manuscript entitled “Healthcare providers’ pain management practice and its associated factors in Ethiopia. Systematic review and meta- analysis: manuscript number “PONE-d-24-12823”. Since pain management is a fundamental aspect of patient care and quality of life, the finding of the manuscript in general has great clinical significance by providing information on the overall pictures of pain management status in Ethiopia and on the areas of improvement to enhance pain management practice of healthcare providers. The study upholds rigorous technical standards across statistical analyses, and methodological procedures. Please find my general and specific comments below.

General comments

� The manuscript has multiple language usage flaws including punctuations, wordings, spelling and mainly grammar errors. These problems are found throughout the manuscript. . Therefore, please make repeated proof-reading and thorough copyediting before considering the manuscript for publication. This would help increase the readability of the manuscript if published..

For instance

� Abstract: Pain defined need to be corrected as pain is defined as

� Under treatment need to be corrected as under-treatment

� Avoid unnecessary spelling in the following sentence. Advancing a national agenda to reduce inconsistencies in pain Care for health policy, education and Practice is very imperative

� Inconsistencies in language usage e.g health care professionals’’ versus health care providers’’????

� Work load need to be written as Workload

Specific comments

1. Title

� The title needs little modification as follows. Healthcare providers’ pain management practice and its associated factors in Ethiopia: A systematic review and met analysis

2. Key words

� I recommended the following as a key words. Pain management practice, health care providers, Ethiopia, Systematic review and meta-analysis

3. Abstract

� The paragraph stating about the factors associated with the outcome variable need to be rewrite to make it legible and easily comprehended

� The following conclusion is not supported by your finding. “Advancing a national agenda to reduce inconsistencies in pain Care for health policy, education and Practice is very imperative

4. Introduction

� The introduction to shall be concentrated on health care providers pain management practice (definition, the figures on magnitude and the inconsistencies in the magnitude, the consequences of poor pain management in terms of quality of life , treatment outcome, healthcare cost…)

� It would be better to add more information significance of the study with regard to the policy makers ( the significance of providing overall figures of pain management practice) , healthcare providers ( training and capacity building activities ) and patients ( in terms of reducing healthcare costs, hospitalization, improving quality of life…)

5. Methods and materials

� Word in their first appearance in the manuscript need to be stated in the full explanation terms. GPs, IESO ..

� On the Operational definition, it is better to add about the tool, the assessment criteria ..that your primary studies were utilized.

6. Result and Discussion

� The discussion need to specifically stated for each independent variables

� Please add the further implication of the finding (both on the prevalence and each associated factors ) in the discussion section.

� Please refine the following paragraph accordingly. “The results of this review and meta- analysis identified that availability of pain management protocol and analgesia[76], educational level, female sex, took training, work load, work experience, type of profession, attitude and knowledge of health care providers towards pain management practice were significantly associated with pain management practice among health care providers. This results consistent with previous studies conducted in Brazil, USA, Saudi Arabia and Ethiopia [77-81]. As previous research has concluded the practice of having health care providers’ pain management strategies for the patients’ can be categorized into three different models, the biomedical model, the non-pharmacological interventions model, and the alternative medicine model, including acupuncture[82-84],the identified factors are pivotal for advancing pain management practice level of health care providers. Training increase job satisfaction and morale that improve productivity and earn more profit which in turn advances

practicing level of health care providers’ pain management.

Thank you

Reviewer #2: Overall comments:

The manuscript’s strengths include the study of pain management practice and associated factors using a systematic review and meta-analysis. A specific strength was the relatively well-documented and presented data analysis performed in the "Results section." The weaknesses unfortunately concern the methodology. There are many aspects that compromise the reliability and replicability of the data. Also, the manuscript is full of grammatical errors. The manuscript requires a grammatical and language edition. Please refer to the attached comments. Thank you.

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: No

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While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Attachments

Attachment

Submitted filename: Comments to the authors on pain managment paractice.docx

Attachment

Submitted filename: Comments to the Author.docx

PONE-D-24-12823R1Healthcare providers’ pain management practice and its associated factors in Ethiopia: A systematic review and meta- analysis.PLOS ONE

Dear Dr. Mekonnen,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.  

Please submit your revised manuscript by Sep 05 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Dereje Zewdu Assefa, BSc, MSc

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: (No Response)

Reviewer #2: Partly

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: No

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear PLoS ONE team of editorials

Thank you for the chance given to me to review a manuscript entitled “Healthcare providers’ pain management practice and its associated factors in Ethiopia: A systematic review and meta- analysis “PONE-d-24-12823”. All the comments were completely addressed by the author. I recommended the acceptance of the paper .

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Attachments

Attachment

Submitted filename: Comments to the Author.docx

Healthcare providers’ pain management practice and its associated factors in Ethiopia: A systematic review and meta- analysis.

PONE-D-24-12823R2

Dear Dr. Mekonnen,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Dereje Zewdu Assefa, BSc, MSc

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: