Kristine Carandang, Elizabeth A. Pyatak, Cheryl L. P. Vigen; Systematic Review of Educational Interventions for Rheumatoid Arthritis. Am J Occup Ther 2016;70(6):7006290020. https://doi.org/10.5014/ajot.2016.021386
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© 2021 American Occupational Therapy Association
OBJECTIVE. In this study, we systematically reviewed the effectiveness of educational interventions falling within the scope of occupational therapy practice for people with rheumatoid arthritis (RA). These interventions included disease education, joint protection and energy conservation, psychosocial techniques, pain management, and a combination category.
METHOD. Two databases, MEDLINE and CINAHL, and select journals were searched for randomized controlled trials published between January 2002 and June 2015. Qualitative synthesis was used for between-study comparisons.
RESULTS. Twenty-two studies, with approximately 2,600 participants, were included. The interventions were found to have strong evidence for constructs that dealt with increasing coping with pain and fatigue as well as maintaining positive affect. There was limited or no evidence supporting the effectiveness of these interventions on most other measured constructs.
CONCLUSION. Interventions in which a combination of educational techniques is used may complement pharmacological therapies in the care of people with RA. Future research is needed to identify specific mechanisms of change.
Given people’s interest in improving psychosocial aspects of managing chronic illness, educational approaches should be incorporated along with other evidence-based approaches, such as remediation, within occupational therapy’s scope of practice.
Strong evidence exists for the effectiveness of various educational occupational therapy approaches to improve pain, tender joints, affect, and coping of people with RA. Joint protection and energy conservation approaches are moderately effective in increasing joint protection behaviors.
People with RA demonstrate heterogeneity across symptoms in response to medications. Tailoring interventions to each person, including symptoms, resources, and readiness to change, may increase applicability to everyday functioning and behaviors.
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