This scoping review provides general information, but not robust conclusive evidence about the effectiveness of occupational therapy for people with chronic diseases

Abstract

SummaryofHand,C.,Law,M.&McColl,M.A.(2011).Occupational therapy interventions for chronic diseases:A scoping review. American Journal of OccupationalTherapy, 65 (4), 428–436.Objective of review: To determine the effectiveness ofcommunity occupational therapy on occupational perfor-mance for people with chronic diseases.Search strategy: Searches included electronic databasesAMED, CINAHL, EMBASE, MEDLINE, the CochraneLibrary and PsycInfo from 1988 to end of 2008 for commu-nity-based or outpatient-focused occupational therapyinterventions and occupational therapy relevant databases,including systematic reviews such as OTseeker. A sensitivesearch strategy was used.Selection criteria: Studies: Randomised controlled trials(RCTs).Participants: community living with one or morecardiovascular disease, COPD, depression, diabetes, osteo-arthritis (OA) or rheumatoid arthritis (RA). Cerebrovascu-lar diseases were excluded. Interventions: An interventiondelivered by community or outpatient occupational thera-pists or as part of a multidisciplinary team containing occu-pational therapists. Outcomes: occupational performance,health status, quality of life or self-efficacy.Method of the review: Two reviewers independently iden-tified relevant trials, assessed methodological quality andextracted data. The methodological quality was assessedusing the McMaster University’s Critical Review Form forQuantitative Studies (Law et al., 1998). Disagreements wereresolved by a third researcher. Qualitative analyses anddata synthesis were performed.Main findings: Sixteen studies of a pool of 141, met all eli-gibility criteria and were included. Studies focused on RA(n = 10), COPD (n = 3), depression (n = 1), chronic heartfailure (n = 1) and multiple conditions (n = 1).Seven studies met all of the methodological quality crite-ria and the others met at least 75%. Ten studies reportedsignificant positiveresults for improvement of occupationalperformance (n = 4), work outcomes for depression(n = 1), meeting social needs in the short term ( n = 2), psy-chological health for RA and COPD (n = 2), health status orquality of life for COPD or chronic heart failure ( n = 3) forpatients who received the interv entions of interest. Positiveoutcomes on physical health were found only for moder-ate-to-severe RA and COPD (n = 2of11).Theinterventionscommonly included goal setting, energy conservation, jointprotection, exercise, assistive devices and coping strategies,and were applied in groups or individually.Authors’ conclusions: Evidence indicates that occupationaltherapy interventions can improve occupational perfor-mance, health, and quality of life for people with chronicdiseases such as RA, COPD, chronic heart failure anddepression.Contact details of original author: handc@mcmaster.caEsther SteultjensCAPs Advisory Board MemberEmail: Esther.Steultjens@han.nl