Effectiveness of Occupational Therapy Interventions for Adults With Rheumatoid Arthritis: A Systematic Review

Siegel, Patricia; Tencza, Melissa; Apodaca, Beverly; Poole, Janet L.

doi:10.5014/ajot.2017.023176

Cited by 62 publications

(56 citation statements)

References 54 publications

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“…This improvement can be found with nonpharmacologic interventions, such as cognitive‐behavioral therapy and relaxation or biofeedback interventions that address pain, functional disability, fatigue, sleep, depressive symptoms, anxiety, coping, self‐efficacy, and even tender joints. Other nonpharmacologic interventions that have been shown to be effective are physical activity , occupational therapy , and patient education . These studies highlight the importance of a team approach to disease management as well as the importance of incorporating the patient's perspective in the overall treatment plan.…”

Section: Discussionmentioning

confidence: 99%

Suppressing Inflammation in Rheumatoid Arthritis: Does Patient Global Assessment Blur the Target? A Practice‐Based Call for a Paradigm Change

Ferreira

Duarte

Ndosi

et al. 2018

Arthritis Care & Research

107

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Objective In current management paradigms of rheumatoid arthritis (RA), patient global assessment (PGA) is crucial to decide whether a patient has attained remission (target) or needs reinforced therapy. We investigated whether the clinical and psychological determinants of PGA are appropriate to support this important role. Methods This was a cross‐sectional, single‐center study including consecutive ambulatory RA patients. Data collection comprised swollen 28‐joint count (SJC28), tender 28‐joint count (TJC28), C‐reactive protein (CRP) level, PGA, pain, fatigue, function, anxiety, depression, happiness, personality traits, and comorbidities. Remission was categorized using American College of Rheumatology/European League Against Rheumatism Boolean‐based criteria: remission, near‐remission (only PGA >1), and nonremission. A binary definition without PGA (3v‐remission) was also studied. Univariable and multivariable analyses were used to identify explanatory variables of PGA in each remission state. Results A total of 309 patients were included (remission 9.4%, near‐remission 37.2%, and nonremission 53.4%). Patients in near‐remission were indistinguishable from remission regarding disease activity, but described a disease impact similar to those in nonremission. In multivariable analyses, PGA in near‐remission was explained (R2adjusted = 0.50) by fatigue, pain, anxiety, and function. Fatigue and pain had no relationship with disease activity measures. Conclusion In RA, a consensually acceptable level of disease activity (SJC28, TJC28, and CRP level ≤1) does not equate to low disease impact: a large proportion of these patients are considered in nonremission solely due to PGA. PGA mainly reflects fatigue, pain, function, and psychological domains, which are inadequate to define the target for immunosuppressive therapy. This consideration suggests that clinical practice should be guided by 2 separate remission targets: inflammation (3v‐remission) and disease impact.

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Section: Discussionmentioning

confidence: 99%

Suppressing Inflammation in Rheumatoid Arthritis: Does Patient Global Assessment Blur the Target? A Practice‐Based Call for a Paradigm Change

Ferreira

Duarte

Ndosi

et al. 2018

Arthritis Care & Research

107

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“…Knowledge about the use of assistive devices among people with advanced cancer is, however, limited. Most research recommending the use of assistive devices tends to focus on people with other chronic conditions (Abdulla et al, 2013;Arbesman & Sheard, 2014;Siegel, Tencza, Apodaca, & Poole, 2017). A systematic review on occupational therapy for community-dwelling elderly people (Steultjens et al, 2004) presents strong evidence of the efficacy of giving advice on relevant assistive devices.…”

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confidence: 99%

The association between having assistive devices and activities of daily living ability and health‐related quality of life: An exploratory cross‐sectional study among people with advanced cancer

et al. 2019

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Objective To explore whether people with advanced cancer who had assistive devices had higher or lower ADL ability and/or HRQoL than people with advanced cancer who did not have assistive devices. Methods A cross‐sectional study of 164 participants with advanced cancer. Self‐reported ADL ability and HRQoL were assessed using the ADL—Interview and the EORTC QLQ‐C30. Data regarding assistive devices were collected using a study‐specific questionnaire. Data were analysed using multiple linear regression. The regression coefficients (B) were presented in crude form and adjusted for potential confounding variables (age, gender, cohabiting, receiving help, physical functioning, fatigue and pain). p‐Values (p) < 0.05 were considered statistically significant. Results Having assistive devices was associated with lower ADL ability (B = −0.923, p = <0.0001), but this association was not significant after adjustment where it was found that physical functioning was a confounder positively associated with ADL ability (B = 0.030, p = <0.0001). No significant association was found between having assistive devices and HRQoL. Both fatigue (B = −0.336, p = <0.0001) and pain (B = −0.124, p = 0.010) were negatively associated with HRQoL. Conclusion The participants had the same ADL ability and HRQoL regardless of them having assistive devices. Interventions addressing physical functioning or fatigue and pain might contribute to enhancing ADL ability and HRQoL among people with advanced cancer.

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“…This scoping study did not evaluate the effectiveness of Joint protection programs but identified 18 RCTs that can be synthesized to investigate their effectiveness. The two most recent systematic reviews (26,27) provided recommendations from 8 RCTs in total leading to the exclusion of 10 additional trials. Therefore, an update of the most recent evidence is highly recommended.…”

Section: Discussionmentioning

confidence: 99%

A Scoping Review of Joint Protection Programs for People with Hand Arthritis

Bobos¹,

Nazari²,

Lalone³

et al. 2018

TOORTHJ

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Background:Joint Protection (JP) can be enhanced by incorporating recent evidence and innovations in collaboration with people with hand arthritis to be salient, useful and effectively implemented.Objective:The purpose of this study is to map the current research on JP principles and guide future research on JP programs for the management of hand arthritis.Methods:A search was performed in 4 databases (PubMed, EMBASE, Google SCHOLAR, CINHAL) from January 1990 to February 2017. A Grey literature was also conducted through the Google web search engine. A combination of search terms was used such as hand osteoarthritis, rheumatoid arthritis, joint protection and/or self-management strategies.Results:Our search found 8,788 citations in which 231 articles were deemed relevant and after duplication 111 articles were retrieved for a full-text review. In total, 40 articles were eligible for data extraction. The majority of the articles were randomized controlled trials (RCTs), systematic reviews and overviews of reviews that investigated joint protection for hand arthritis. Joint protection was tested mostly in rheumatoid arthritis (RA) population and to a lesser extent on hand osteoarthritis and was provided mainly by an occupational therapist.Conclusion:This review synthesized and critically examined the scope of JP for the management of hand arthritis and found that RCTs, systematic reviews and overviews of reviews constituted two-thirds of the current body of literature. Furthermore, it identified a lack of clarity regarding the specific elements of joint protection programs used in clinical studies.

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Effectiveness of Occupational Therapy Interventions for Adults With Rheumatoid Arthritis: A Systematic Review

Abstract: The evidence supports interventions within the scope of occupational therapy practice for rheumatoid arthritis, but few interventions were occupation based.

Cited by 62 publications

References 54 publications

Suppressing Inflammation in Rheumatoid Arthritis: Does Patient Global Assessment Blur the Target? A Practice‐Based Call for a Paradigm Change

Suppressing Inflammation in Rheumatoid Arthritis: Does Patient Global Assessment Blur the Target? A Practice‐Based Call for a Paradigm Change

The association between having assistive devices and activities of daily living ability and health‐related quality of life: An exploratory cross‐sectional study among people with advanced cancer

A Scoping Review of Joint Protection Programs for People with Hand Arthritis

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