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The Impact of Occupational Therapy on the Self‐Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review

Gavin, James P.; Rossiter, Laura; Fenerty, Vicky; Leese, Jenny; Adams, Jo; Hammond, Alison; Davidson, Eileen; Backman, Catherine L.

The Impact of Occupational Therapy on the Self‐Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review Thumbnail


Authors

James P. Gavin

Laura Rossiter

Vicky Fenerty

Jenny Leese

Jo Adams

Eileen Davidson

Catherine L. Backman



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 gray literature were searched up to June 30, 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 (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE‐ Confidence in Evidence from Reviews of Qualitative research (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.

Citation

Gavin, J. P., Rossiter, L., Fenerty, V., Leese, J., Adams, J., Hammond, A., …Backman, C. L. (in press). The Impact of Occupational Therapy on the Self‐Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review. ACR Open Rheumatology, https://doi.org/10.1002/acr2.11650

Journal Article Type Article
Acceptance Date Dec 11, 2023
Online Publication Date Feb 8, 2024
Deposit Date Feb 16, 2024
Publicly Available Date Feb 16, 2024
Journal ACR Open Rheumatology
Print ISSN 2578-5745
Publisher Wiley Open Access
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1002/acr2.11650

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