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Abstract
Objective To perform a systematic review (SR) on the effectiveness of self-management interventions, in order to inform the European League Against Rheumatism Recommendations for its implementation in patients with inflammatory arthritis (IA).
Methods The SR was conducted according to the Cochrane Handbook and included adults (≥18 years) with IA. The search strategy was run in Medline through PubMed, Embase, Cochrane Library, CINAHL Plus with Full Text, and PEDro. The assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. A narrative Summary of Findings was provided according to the Grading of Recommendations, Assessment, Development and Evaluation.
Results From a total 1577 references, 57 were selected for a full-text review, and 32 studies fulfilled the inclusion criteria (19 randomised controlled trials (RCTs) and 13 SRs). The most studied self-management components were specific interactive disease education in ten RCTs, problem solving in nine RCTs, cognitive–behavioural therapy in eight RCTs, goal setting in six RCTs, patient education in five RCTs and response training in two RCTs. The most studied interventions were multicomponent or single exercise/physical activity in six SRs, psychosocial interventions in five SRs and education in two SRs. Overall, all these specific components and interventions of self-management have beneficial effects on IAs-related outcomes.
Conclusions The findings confirm the beneficial effect of the self-management interventions in IA and the importance of their implementation. Further research should focus on the understanding that self-management is a complex intervention to allow the isolation of the effectiveness of its different components.
- arthritis
- rheumatoid
- arthritis
- psoriatic
- spondylitis
- ankylosing
- outcome assessment
- health care
- inflammation
Data availability statement
Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as supplementary information. Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as supplementary information.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
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Data availability statement
Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as supplementary information. Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as supplementary information.
Supplementary materials
Supplementary Data
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Footnotes
Twitter @EduardoJFSantos, @ElenaNikiUK, @carmona_loreto
Collaborators Ailsa Bosworth (UK) ailsa@nras.org.uk; Elena Nikiphorou (UK) enikiphorou@gmail.com; Loreto Carmona (Spain) loreto.carmona@inmusc.eu; Andrea Marques (Portugal) andreamarques23@gmail.com; Eduardo Santos (Portugal) ejf.santos87@gmail.com; Claire Daien (France) cidaien@gmail.com; Codruta Zabalan (Romania) codruta.filip@gmail.com; George Fragoulis (Greece) geofragoul@yahoo.gr; Bente Appel Esbensen (Denmark) bente.appel.esbensen@regionh.dk; Annette de Thurah (Denmark) annethur@rm.dk; George Metsios (UK) g.metsios@wlv.ac.uk; Hans Biljsma (Netherlands) j.w.j.bijlsma@umcutrecht.nl; Hayley McBain (UK) hayley.mcbain.1@city.ac.uk; Pat Holmes (UK) patricia.karma22@gmail.com; Peter Boehm (Germany) peboehm@gmx.de; Ricardo Ferreira (Portugal) ferreira.rjo@gmail.com; Rikke Helene Moe (Norway) rikmoe@gmail.com; Sarah Ryan (UK) sarah.ryan@uhns.nhs.uk; Tanja Stamn (Austria) tanja.stamm@meduniwien.ac.at.
Contributors All authors are members of the EULAR’s task force for the development of 2021 EULAR Recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. AM and ES were the fellows. EN and AB were the convenors. LC was the methodologist. All authors have contributed to the work, read and finally approved the manuscript for submission.
Funding This study was funded by the European League Against Rheumatism EULAR (Project (PARE-led) PAR028: EULAR Recommendations for the implementation of self-management strategies in patients with Inflammatory Arthritis.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.