Self-management interventions in systemic sclerosis: A systematic review.
Robyn K Wojeck, Donald E Bailey, Tamara J Somers and 1 others
PMID 33651396WHAT IT FOUND
Self-management programs for adults with systemic sclerosis varied widely.
Effects on patients' confidence and overall health were inconsistent. Many studies were small and of poor quality, so no program can be recommended as proven.
Key findings
01Sixteen studies met eligibility; 7 were randomized controlled trials, sample sizes ranged from 6 to 267, and 12 studies had fewer than 50 participants.
02The interventions varied: 7 focused on physical function through rehabilitation, 4 on disease knowledge, 3 on multidisciplinary team education, 1 on complementary therapy, and 1 on transcutaneous electrical nerve stimulation.
03Effects were inconsistent: patient activation improved in a 16-participant study but not in a 267-participant randomized trial, and global health improved in 8 studies.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 16 studies were included, and 12 had fewer than 50 participants. Only 5 studies were published in the last five years. No study had excellent methodological quality, and 7 were poor quality. Interventions varied in content and length, from six days to one year. The included studies did not report treatment fidelity. Most studies did not include a power analysis. Samples were mostly Caucasian, married females, so results may not apply to all adults with systemic sclerosis. Only English-language studies were included.
The easy way to misread this
Do not read this review as showing that self-management programs improve systemic sclerosis outcomes. Effects were inconsistent, many studies were small, and methodological quality was poor.