Effectiveness of nonpharmacological and nonsurgical interventions for patients with rheumatoid arthritis: an overview of systematic reviews.
Conclusions based on systematic reviews of randomized controlled trials are considered to provide the highest level of evidence about the effectiveness of an intervention. This overview summarizes the available evidence from systematic reviews on the effects of nonpharmacological and nonsurgical interventions for rheumatoid arthritis (RA). Systematic reviews of studies of patients with RA (aged >18 years) published between 2000 and 2007 were identified by comprehensive literature searches. Methodological quality was independently assessed by 2 authors, and the quality of evidence was summarized by explicit methods. Pain, function, and patient global assessment were considered primary outcomes of interest. Twenty-eight systematic reviews were included in this overview. High-quality evidence was found for beneficial effects of joint protection and patient education, moderate-quality evidence was found for beneficial effects of herbal therapy (gamma-linolenic acid) and low-level laser therapy, and low-quality evidence was found for the effectiveness of the other interventions. The quality of evidence for the effectiveness of most nonpharmacological and nonsurgical interventions in RA is moderate to low.
Christie
Anne
A
National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, PO Box 23 Vindern, 0319 Oslo, Norway. anne.christie@nrrk.no
Jamtvedt
Gro
G
Dahm
Kristin Thuve
KT
Moe
Rikke H
RH
Haavardsholm
Espen A
EA
Hagen
Kåre Birger
KB
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000534:rehabilitation*; D004185:Disability Evaluation; D006801:Humans; D028022:Low-Level Light Therapy; D009989:Orthotic Devices; D010147:Pain Measurement; D010353:Patient Education as Topic; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D017965:gamma-Linolenic Acid / Q000627:therapeutic use
D017965:gamma-Linolenic Acid