The impact of occupational therapy on the self-management of rheumatoid arthritis: a mixed methods systematic review
The impact of occupational therapy on the self-management of rheumatoid arthritis: a mixed methods systematic review
Objective: to determine the impact of occupational therapy (OT) on the self-management of function, pain, fatigue and lived experience for people living with rheumatoid arthritis (RA).
Methods: five databases and grey literature were searched up to 30 June 2022. Three reviewers screened titles and abstracts, with two independently extracting and assessing full texts using the Cochrane risk of bias (quantitative) and Critical Appraisal Skills Programme (CASP) (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE-CERQual (qualitative) were used to assess the quality of evidence for each intervention type.
Results: of 39 eligible papers, 29 were quantitative (n=2,029), 4 qualitative (n=50) and 6 mixed methods (n=896). Good evidence supports patient education and behavior change programs for improving pain and function, particularly group sessions of joint protection education, but these do not translate to long-term improvements for RA (>24 months). Comprehensive OT had mixed evidence (limited to home OT and an arthritis gloves program), whereas limited evidence was available for qualitative insights, splints and assistive devices, and self-management for fatigue.
Conclusion: although patient education is promising for self-managing RA, no strong evidence was found to support OT programs for self-managing fatigue or patient experience and long-term effectiveness. More research is required on lived experience and the long-term efficacy of self-management approaches incorporating OT, particularly timing programs to meet the individual’s conditional needs (i.e., early or established RA) to build on the few studies to date.
Gavin, James P.
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Rossiter, Laura
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Fenerty, Vicky
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Leese, Jenny
5e899d9c-ab1e-4927-b620-5d2e8d63296a
Adams, Jo
6e38b8bb-9467-4585-86e4-14062b02bcba
Hammond, Alison
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Davidson, Eileen
61168ff3-59f3-48f7-91ce-bac2e2107ef0
Backman, Catherine L.
2d50a52b-4ebc-4d80-9f03-23404b0cf973
Gavin, James P.
e0d9b404-3f63-4855-8e64-bf1692e6cc3f
Rossiter, Laura
03e84799-86ea-41ac-96d9-d424767dcac0
Fenerty, Vicky
5edbe55b-e185-4e44-a81d-34065cc28df7
Leese, Jenny
5e899d9c-ab1e-4927-b620-5d2e8d63296a
Adams, Jo
6e38b8bb-9467-4585-86e4-14062b02bcba
Hammond, Alison
bcbbb91c-3084-4c68-8aa6-4a5062703ecb
Davidson, Eileen
61168ff3-59f3-48f7-91ce-bac2e2107ef0
Backman, Catherine L.
2d50a52b-4ebc-4d80-9f03-23404b0cf973
Gavin, James P., Rossiter, Laura, Fenerty, Vicky, Leese, Jenny, Adams, Jo, Hammond, Alison, Davidson, Eileen and Backman, Catherine L.
(2023)
The impact of occupational therapy on the self-management of rheumatoid arthritis: a mixed methods systematic review.
ACR Open Rheumatology.
(In Press)
Abstract
Objective: to determine the impact of occupational therapy (OT) on the self-management of function, pain, fatigue and lived experience for people living with rheumatoid arthritis (RA).
Methods: five databases and grey literature were searched up to 30 June 2022. Three reviewers screened titles and abstracts, with two independently extracting and assessing full texts using the Cochrane risk of bias (quantitative) and Critical Appraisal Skills Programme (CASP) (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE-CERQual (qualitative) were used to assess the quality of evidence for each intervention type.
Results: of 39 eligible papers, 29 were quantitative (n=2,029), 4 qualitative (n=50) and 6 mixed methods (n=896). Good evidence supports patient education and behavior change programs for improving pain and function, particularly group sessions of joint protection education, but these do not translate to long-term improvements for RA (>24 months). Comprehensive OT had mixed evidence (limited to home OT and an arthritis gloves program), whereas limited evidence was available for qualitative insights, splints and assistive devices, and self-management for fatigue.
Conclusion: although patient education is promising for self-managing RA, no strong evidence was found to support OT programs for self-managing fatigue or patient experience and long-term effectiveness. More research is required on lived experience and the long-term efficacy of self-management approaches incorporating OT, particularly timing programs to meet the individual’s conditional needs (i.e., early or established RA) to build on the few studies to date.
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Accepted/In Press date: 21 November 2023
Identifiers
Local EPrints ID: 485852
URI: http://eprints.soton.ac.uk/id/eprint/485852
ISSN: 2578-5745
PURE UUID: 30372858-a8d4-4bd2-8e14-29e9a11bbf09
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Date deposited: 20 Dec 2023 17:40
Last modified: 18 Mar 2024 03:51
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Contributors
Author:
Laura Rossiter
Author:
Vicky Fenerty
Author:
Jenny Leese
Author:
Alison Hammond
Author:
Eileen Davidson
Author:
Catherine L. Backman
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