Reaching those most in need: a scoping review of interventions to improve health care quality for disadvantaged populations with osteoarthritis.
OBJECTIVE
To conduct a systematic review to identify and describe the scope and nature of the research evidence on the effectiveness of interventions to improve health care quality or reduce disparities in the care of disadvantaged populations with osteoarthritis (OA) as an example of a common chronic disease.


METHODS
We searched electronic databases from 1950 through February 2010 and grey literature for relevant articles using any study design. Studies with interventions designed explicitly to improve health care quality or reduce disparities in the care of disadvantaged adult populations with OA and including an evaluation were eligible. We used the PROGRESS-Plus framework to identify disadvantaged population subgroups.


RESULTS
Of 4,701 citations identified, 10 met the inclusion criteria. Eight were community based and 6 targeted race/ethnicity/culture. All 10 studies evaluated interventions aimed at people with OA; 2 studies also targeted the health care system. No studies targeted health care providers. Nine of 10 studies evaluated arthritis self-management interventions; all showed some benefit. Only 1 study compared the difference in effect between the PROGRESS-Plus disadvantaged population and the relevant comparator group.


CONCLUSIONS
There are few studies evaluating the effectiveness of interventions to improve health care quality in disadvantaged populations with OA. Further research is needed to evaluate interventions aimed at health care providers and the health care system, as well as other patient-level interventions. Gap intervention research is also needed to evaluate whether interventions are effective in reducing documented health care inequities.
Borkhoff
Cornelia M
CM
Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. cory.borkhoff@wchospital.ca
Wieland
Mark L
ML
Myasoedova
Elena
E
Ahmad
Zareen
Z
Welch
Vivian
V
Hawker
Gillian A
GA
Li
Linda C
LC
Buchbinder
Rachelle
R
Ueffing
Erin
E
Beaton
Dorcas
D
Cardiel
Mario H
MH
Gabriel
Sherine E
SE
Guillemin
Francis
F
Adebajo
Ade O
AO
Bombardier
Claire
C
Hajjaj-Hassouni
Najia
N
Tugwell
Peter
P
D006301:Health Services Needs and Demand / Q000191:economics / Q000592:standards*; D006801:Humans; D010003:Osteoarthritis / Q000191:economics / Q000628:therapy*; D011787:Quality of Health Care / Q000191:economics / Q000592:standards*; D035862:Vulnerable Populations