Patient education for adults with rheumatoid arthritis

Riemsma, R.P.; Kirwan, John R.; Taal, Erik; Rasker, H.

doi:10.1002/14651858.cd003688

Cited by 201 publications

(179 citation statements)

References 93 publications

Supporting

Mentioning

144

Contrasting

Unclassified

Order By: Relevance

“…Confirming the results of previous researchers (17,18), neither CBT, patient education, nor stress management interventions produced effect sizes that were significantly greater than the others. As previously noted (64), CBT, patient education, and stress management interventions utilize overlapping techniques derived from multiple theoretical backgrounds (Table 1).…”

supporting

confidence: 79%

“…The set of psychological interventions included in this analysis had small effects upon the physical and psychological outcomes of RA. The effect sizes (Hedges' g) calculated for pain (0.18), disability (0.32), depressive symptoms (0.23), and anxiety (0.17) are significant, small, and similar to those calculated in previous meta-analyses examining psychological treatments for RA (17,18) and mixed arthritis populations (4). These small effect sizes occur in addition to what is achieved by standard care alone, thereby illustrating the possible utility of such treatments in practice.…”

supporting

confidence: 71%

“…Several previous meta-analyses have shown that psychological interventions produce small significant effect sizes upon physical and psychological outcomes important in RA (4,17,18). However, to our knowledge, no metaanalysis has yet assessed the effects of psychological interventions upon levels of physical activity among patients with RA.…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Psychological interventions for rheumatoid arthritis: Examining the role of self‐regulation with a systematic review and meta‐analysis of randomized controlled trials

Knittle¹,

Maes²,

Gucht³

2010

Arthritis Care & Research

136

View full text Add to dashboard Cite

Objective. To examine the efficacy of psychological interventions for rheumatoid arthritis (RA), and to determine whether self-regulation interventions demonstrate efficacy superior to that of other psychological treatments. Methods. Only randomized controlled trials testing a face-to-face psychological intervention among patients with RA were included. Two independent investigators extracted pertinent study data, rated each study on a scale of methodologic quality, and assessed each treatment condition for its inclusion of 5 behavior-change techniques derived from selfregulation theory (goal setting, planning, self-monitoring, feedback, and relapse prevention). Results. Twenty-seven trials were included, and cumulative effect sizes were calculated for the 5 outcomes. Significant effect sizes (Hedges' g) were found at posttreatment for physical activity (0.45), pain (0.18), disability (0.32), depressive symptoms (0.23), and anxiety (0.17). At followup (range 2-14 months), significant effect sizes were obtained for physical activity (0.36), pain (0.13), disability (0.15), and depressive symptoms (0.32). Comparative analyses revealed that interventions utilizing more self-regulation techniques reduced depressive symptoms and anxiety significantly more than interventions utilizing fewer such techniques. Additionally, depressive symptoms were reduced significantly more among recently diagnosed RA patients than among those with longstanding RA. Conclusion. Psychological interventions are beneficial for many patients with RA, particularly when it comes to increasing physical activity levels. Intervention techniques derived from self-regulation theory appear to play a role in reducing depressive symptoms and anxiety among patients with RA.

show abstract

supporting

confidence: 79%

supporting

confidence: 71%

See 1 more Smart Citation

Psychological interventions for rheumatoid arthritis: Examining the role of self‐regulation with a systematic review and meta‐analysis of randomized controlled trials

Knittle¹,

Maes²,

Gucht³

2010

Arthritis Care & Research

136

View full text Add to dashboard Cite

show abstract

“…[181][182][183][184][185][186][187][188][189][190] These reviews represented a total of 132 RCTs, though after excluding overlaps this represented 66 unique RCTs, published between 1981 and 2010 ( Figure 36).…”

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

“…Six of the reviews 181,182,184,[186][187][188] looked at RA exclusively, one looked at SLE 190 and three looked at multiple LTCs (not exclusively IAs) but reported results for RA separately (Table 85).…”

Section: Systematic Reviews Identifiedmentioning

confidence: 99%

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Taylor

Pinnock

Epiphaniou

et al. 2014

Health Services and Delivery Research

344

451

View full text Add to dashboard Cite

BackgroundDespite robust evidence concerning self-management for some long-term conditions (LTCs), others lack research explicitly on self-management and, consequently, some patient groups may be overlooked.AimTo undertake a rapid, systematic overview of the evidence on self-management support for LTCs to inform health-care commissioners and providers about what works, for whom, and in what contexts.MethodsSelf-management is ‘the tasks . . . individuals must undertake to live with one or more chronic conditions . . . [including] . . . having the confidence to deal with medical management, role management and emotional management of their conditions’. We convened an expert workshop and identified characteristics of LTCs potentially of relevance to self-management and 14 diverse exemplar LTCs (stroke, asthma, type 2 diabetes mellitus, depression, chronic obstructive pulmonary disease, chronic kidney disease, dementia, epilepsy, hypertension, inflammatory arthropathies, irritable bowel syndrome, low back pain, progressive neurological disorders and type 1 diabetes mellitus). For each LTC we conducted systematic overviews of systematic reviews of randomised controlled trials (RCTs) of self-management support interventions (‘quantitative meta-reviews’); and systematic overviews of systematic reviews of qualitative studies of patients’ experiences relating to self-management (‘qualitative meta-reviews’). We also conducted an original systematic review of implementation studies of self-management support in the LTCs. We synthesised all our data considering the different characteristics of LTCs. In parallel, we developed a taxonomy of the potential components of self-management support.ResultsWe included 30 qualitative systematic reviews (including 515 unique studies), 102 quantitative systematic reviews (including 969 RCTs), and 61 studies in the implementation systematic review. Effective self-management support interventions are multifaceted, should be tailored to the individual, their culture and beliefs, a specific LTC and position on the disease trajectory, and underpinned by a collaborative/communicative relationship between the patient and health-care professional (HCP) within the context of a health-care organisation that actively promotes self-management. Self-management support is a complex intervention and although many components were described and trialled in the studies no single component stood out as more important than any other. Core components include (1) provision of education about the LTC, recognising the importance of understanding patients’ pre-existing knowledge and beliefs about their LTC; (2) psychological strategies to support adjustment to life with a LTC; (3) strategies specifically to support adherence to treatments; (4) practical support tailored to the specific LTC, including support around activities of daily living for disabling conditions, action plans in conditions subject to marked exacerbations, intensive disease-specific training to enable self-management of specific clinical tasks; and (5) social support as appropriate. Implementation requires a whole-systems approach which intervenes at the level of the patient, the HCP and the organisation. The health-care organisation is responsible for providing the means (both training and time/material resources) to enable HCPs to implement, and patients to benefit from, self-management support, regularly evaluating self-management processes and clinical outcomes. More widely there is a societal need to address public understanding of LTCs. The lack of public story for many conditions impacted on patient help-seeking behaviour and public perceptions of need.ConclusionsSupporting self-management is inseparable from the high-quality care for LTCs. Commissioners and health-care providers should promote a culture of actively supporting self-management as a normal, expected, monitored and rewarded aspect of care. Further research is needed to understand how health service managers and staff can achieve this culture change in their health-care organisations.Study registrationThis study is registered as PROSPERO CRD42012002898.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Information provision for stroke patients and their caregivers

Smith

Forster

House

et al. 2008

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Patient education for adults with rheumatoid arthritis

Abstract: Patient education as provided in the studies reviewed here had moderate short-term effects on patient global assessment, and small short-term effects on disability, joint counts and psychological status. There were no long-term benefits.

Cited by 201 publications

References 93 publications

Psychological interventions for rheumatoid arthritis: Examining the role of self‐regulation with a systematic review and meta‐analysis of randomized controlled trials

Psychological interventions for rheumatoid arthritis: Examining the role of self‐regulation with a systematic review and meta‐analysis of randomized controlled trials

A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – Practical systematic RevIew of Self-Management Support for long-term conditions

Information provision for stroke patients and their caregivers

Contact Info

Product

Resources

About