Abstract

Systematic reviews of self-management programs for osteoarthritis suggest minimal evidence of benefit and indicate substantial heterogeneity in interventions. The purpose of this scoping review was to describe the nature of self-management interventions provided to patients with osteoarthritis focusing on the inclusion and type of education and social support components. We searched PsycINFO, EMBASE, MEDLINE, and Cochrane Library databases from 1990 to 2016 to identify studies addressing community-based management strategies for osteoarthritis that included aspects of disease-specific education and ongoing social support. Results are presented as a narrative synthesis to facilitate integration of diverse evidence. Data were extracted from 23 studies that met our inclusion and exclusion criteria, describing complex, multicomponent interventions for osteoarthritis. All studies included education components, and 18 of these were osteoarthritis-specific. Social support was most often offered through peers and health care professionals, but also through exercise trainers/instructors and researchers, and lasted between 5 and 52 weeks. We charted positive social interaction offered by peers in group settings and emotional/informational support offered by health care professionals. Overall, descriptions of self-management provided limited documentation of the rationale or content of the programs. This suggests that more precise definitions of the theoretical underpinnings, components, and mechanisms would be useful for greater insight into best practices for osteoarthritis self-management programs.

Highlights

  • Osteoarthritis (OA) is a chronic disease that causes pain and disability, affecting 1 in every 2 older adults over the age of 65 [1]

  • Synthesis of our results revealed that all interventions included patients with osteoarthritis, but only 18 interventions offered osteoarthritis-specific education

  • We categorize social support based on positive social interaction occurring among peers in group-based interventions, and emotional/informational support received from health care professionals during delivery of the interventions

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Summary

Introduction

Osteoarthritis (OA) is a chronic disease that causes pain and disability, affecting 1 in every 2 older adults over the age of 65 [1]. Self-management programs have been reported for several chronic conditions, including osteoarthritis [2, 3]. These programs are typically behavioural interventions that encourage people to take an active role in managing their own condition by providing education and management strategies [4]. A systematic review of self-management education programs for osteoarthritis found low to moderate quality evidence to suggest that these programs result in no or small benefit, but are unlikely to cause harm [5]. Self-management programs may be challenging for older adults who are managing multiple morbidities [3]

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