Strategies to improve equitable access to early osteoarthritis diagnosis and management: Updated review.

Abstract

While OA affects millions of people worldwide, many fail to access recommended early, person-centred OA care, particularly women who are disproportionately impacted by OA. A prior review identified few strategies to improve equitable access to early diagnosis and management for multiple disadvantaged groups. We aimed to update that review with literature published in 2010 or later on strategies to improve OA care for disadvantaged groups including women. We identified only 11 eligible studies of which only 2 (18%) focused on women only. Other disadvantaged groups targeted in the largely United States-based studies included Black, Spanish-speaking, rural and older (aged 60+) adults. All studies evaluated interventions targeted to patients: 4 (36%) assessed video decision aids and 7 (63.6%) assessed in-person, video or telephone self-management education. Interventions were often multi-faceted (9, 82%) and most studies (8, 73%) achieved positive outcomes in at least some outcomes measured. No studies evaluated clinician- or system-level strategies. Few (5, 45%) studies described how they tailored strategies to disadvantaged groups, or how they addressed person-centred care concepts apart from enabling self-management. Future research is needed to develop, implement, evaluate and scale-up multi-level strategies to enhance equitable, person-centred OA care for disadvantaged groups including women.