Pedersen, MB, Thinggaard, P, Geenen, R et al. (14 more authors) (2023) Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis: A systematic review and meta‐analysis of randomized trials. Arthritis Care & Research, 75 (2). pp. 423-436. ISSN 2151-464X
Abstract
OBJECTIVE
To assess the benefits and harms associated with biopsychosocial rehabilitation in patients with inflammatory arthritis (IA) and osteoarthritis (OA).
METHODS
We performed a systematic review and meta-analysis. Data were collected through electronic searches of Cochrane CENTRAL, Medline, Embase, PsycINFO, and CINAHL databases up to March 2019. Trials examining the effect of biopsychosocial rehabilitation in adults with IA and/or OA were considered eligible, excluding rehabilitation adjunct to surgery. The primary outcome for benefit was pain, and total withdrawals for harm.
RESULTS
Of the 27 trials meeting the eligibility criteria, 22 trials (3,750 participants) reported sufficient data to be included in the quantitative synthesis. For patient reported outcome measures, biopsychosocial rehabilitation was slightly superior to control for pain relief (SMD -0.19 [95%CI, -0.31 to -0.07]), had a small effect on patient global (SMD -0.13 [95%CI, -0.26 to -0.00]), with no apparent effect on health-related quality of life, fatigue, self-reported disability/physical function, mental well-being, and reduction in pain intensity ≥30%. Clinician measured outcomes displayed a small effect on observed disability/physical function (SMD -0.34 [95%CI, -0.57 to -0.10]), a large effect on physician global score (SMD -0.72 [95%CI, -1.18 to -0.26]), and no effect on inflammation. No difference in harms for number of withdrawals, adverse events, or serious adverse events.
CONCLUSIONS
Biopsychosocial rehabilitation produces a significant but clinically small beneficial effect on patient-reported pain among patients with IA and OA, with no difference in harm. Methodological weaknesses were observed in the included trials, suggesting low to moderate confidence in the estimates of effect.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This article is protected by copyright. All rights reserved. This is the peer reviewed version of the following article: Pedersen, M.B., Thinggaard, P., Geenen, R., Rasmussen, M.U., De Wit, M., March, L., Mease, P., Choy, E., Conaghan, P.G., Simon, L., Hansen, A.F., Tarp, S., Schiøttz-Christensen, B., Juhl, C.B., Nielsen, S.M., Amris, K. and Christensen, R. (2022), Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis: A systematic review and meta-analysis of randomized trials. Arthritis Care Res. Accepted Author Manuscript. , which has been published in final form at https://doi.org/10.1002/acr.24816. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Musculoskeletal Medicine & Imaging (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 24 Feb 2022 14:42 |
Last Modified: | 02 Mar 2023 16:18 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1002/acr.24816 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:184034 |