axSpA患者教育项目的有效性:随机对照试验的系统回顾。

IF 1.4 4区 医学 Q3 RHEUMATOLOGY
ARP Rheumatology Pub Date : 2024-10-01
Luisa Brites, Rita Cunha, Helena Santos, Helena Donato, Fernando Pimentel-Santos
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引用次数: 0

摘要

导读:目前脊柱炎(SpA)患者的标准护理,除了药物治疗外,还包括定期运动和患者教育。(1)本系统文献综述(SLR)的主要目的是更新教育计划对轴向SpA (axSpA)患者有效性的证据。方法:系统检索PubMed、Embase和Web of Science Core Collection三个数据库,检索时间为2000年1月至2023年6月,检索术语为:“患者教育”、“患者咨询”、“患者教学”、“患者参与”、“患者授权”、“健康教育”、“脊柱炎”、“关节病”、“脊柱炎”和“强直性脊柱炎”。采用“总体(P)”、“干预(I)”、“比较(C)”、“结果(O)”、PICO标准。“P”,定义为axSpA,“I”为教育程度,“C”为标准护理或体育锻炼,“O”为疾病活动,浴缸强直性脊柱炎疾病活动指数(BASDAI),强直性脊柱炎疾病活动评分(ASDAS);疾病功能反应,浴缸强直性脊柱炎功能指数(BASFI);疾病计量反应,浴缸强直性脊柱炎计量指数(BASMI);疾病生活质量:生活质量(ASQoL)、EuroQol-5D (EQ-5D)和sf - 36健康调查表(SF36);疾病经济影响、成本效用、成本效益和增量成本效益比(ICER)。仅纳入随机临床试验。两名审稿人根据既定标准独立评估已确定的论文并提取数据。结果:从最初确定的494项研究中,选择6项进行数据提取和定性分析。研究样本量在41-65人之间,所有人都被诊断患有强直性脊柱炎。项目负责人各不相同,干预期为4-12周,随访期为3-12个月。在三项研究中,比较者是标准护理,另外三项研究是体育锻炼。总体而言,应用教育方案后BASDAI、BASFI、BASMI、ASQoL和SF-36均有改善。没有研究评估教育项目的经济影响。结论:教育似乎是axSpA患者非药物治疗的重要辅助手段,可以提高各种疾病的预后,特别是当卫生专业人员使用小册子等物理材料时。然而,仍需要进一步的研究来获得更有力的结论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of education programs on axSpA patients: a systematic review of randomized controlled trials.

Introduction: The current standard of care of patients with spondyloarthritis (SpA), in addition to pharmacological treatment, includes regular exercise and patient education.(1) The primary goal of this systematic literature review (SLR) is to update the evidence of the effectiveness of education programs for patients with axial SpA (axSpA).

Methods: We systematically searched three databases, PubMed, Embase and Web of Science Core Collection, from January 2000 to June 2023, using the following terms: "patient education", "patient counselling", "patient teaching", "patient engaging", "patient empowerment", "health education", "spondyloarthritis", "spondyloarthropaties", "spondylitis" and "ankylosing spondylitis". The "Population (P)", "Intervention (I)", "Comparator (C)", "Outcome (O)", PICO criteria were used. "P", defined as axSpA, "I" as education, "C" as standard of care or physical exercise and "O" as disease activity, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS); disease functional repercussion, Bath Ankylosing Spondylitis Functional Index (BASFI); disease metrological repercussion, Bath Ankylosing Spondylitis Metrological Index (BASMI); disease quality of life Ankylosing Spondylitis Quality of Life (ASQoL), EuroQol-5D (EQ-5D) and Short Form 36 Health Survey (SF36); disease economic impact, cost-utility, cost-benefit and incremental cost-effectiveness ratio (ICER). Only randomized clinical trials were included. Two reviewers independently assessed the identified papers according to the established criteria and extracted the data.

Results: From the initial 494 studies identified, 6 were selected for data extraction and qualitative analysis. The study sample sizes ranged between 41-65 individuals, all diagnosed with ankylosing spondylitis. The leaders of the programs varied, the intervention period ranged between 4-12 weeks and the follow up ranged between 3-12 months. In three studies, the comparator was standard of care, and in the other three was physical exercise. Overall, there was an improvement in BASDAI, BASFI, BASMI, ASQoL and SF-36, after the application of educational programs. No studies evaluated the economic impact of educational programs.

Conclusion: Education appears to be an important adjuvant as non-pharmacological treatment for patients with axSpA, enhancing various disease outcomes, particularly when delivered by Health Professionals using physical materials such as pamphlets. However, there is an ongoing need for additional research to obtain more robust conclusions.

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