Self-Management for Inflammatory Arthritis Valuable, But Best Interventions Remain Vague

Self-management interventions are beneficial for patients with inflammatory arthritis, confirms a systematic review published online in RMD Open. 

The review was conducted to inform European League Against Rheumatism recommendations for self-management strategies in patients with inflammatory arthritis. Among 57 studies that underwent full-text review, 32 met inclusion criteria: 19 randomized controlled trials (RCTs) and 13 systematic reviews. 

The components of self-management interventions most studied were interactive disease education (10 RCTs), problem solving (9 RCTs), cognitive-behavioral therapy (8 RCTs), goal setting (6 RCTs), patient education (5 RCTs), and response training (2 RCTs), according to the study. Interventions most studied were exercise/physical activity (6 systematic reviews), psychosocial interventions (5 systematic reviews), and education (2 systematic reviews). 

Although all of the specific components and interventions showed beneficial effects on overall outcomes related to inflammatory arthritis and confirm their importance, researchers said it was difficult to recommend particular interventions. They cited a lack of studies reporting on well-structured self-management programs, the reality of sociodemographic variables affecting patients, and the challenge of analyzing self-management interventions centered in hospitals, “which is distorted by the very concept of self-management interventions,” they wrote. 

“At last, there are even challenges in better defining which outcomes should be measured in self-management interventions,” they concluded. “In the future, a formal outcomes core set should be established in self-management interventions.”

Reference: 

Marques A, Santos E, Nikiphorou E, Bosworth A, Carmona L. Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. RMD Open. 2021;7(2):e001647. doi:10.1136/rmdopen-2021-001647