Non-pharmacological Community Intervention, Especially Pain Management, in Rheumatoid Arthritis: A Review of the Literature

Abstract

Objective: Rheumatoid arthritis (RA) is a crippling disease with significant impact on a patient’s life. The objective of this study is to describe the role of unimodular and multi-modular, non-pharmacological community intervention effectiveness, especially pain management interventions in RA. Methods: This review is built on a preliminary liter-ture search, covering -009 up -o December 2013. Selective review o fcurrent literature was produced by searchingfor the terms ‘nonpharmacological intervention’, ‘self-management programme’, ‘self-care’, and ‘rheumatoid arthritis’, to capture all spectrums of RA non-pharmacological interventions. Twenty-six reviews were included in this overview. Results: A substantial and remarkable number of studies of non-drug care interventions in RA are available. Twenty-six reviews were included in the present overview, which indicated a beneficial effect o f cognitive behavioural therapy and psychotherapeutic intervention, selfmanagement, andphysical therapy (exercise), but afew studies indicated a beneficial effect o f the multi-disciplinary education programme and specific dietary interventions. The evidence o f effectiveness varies among the different non-pharmacological modalities and indicates a need-orfurther -nvestigation -nto -he most clinical and cost-effective -trategies -o -eliver -ndividual, non-pharmacological treatment modalities, as well as comprehensive arthritis service delivery models for patients with RA. Conclusion: This article gives a summary o f the av-ilable evidence -egarding -he -ffectiveness of non-pharmacological treatment modalities which are often prescribed as an adjunct to standard care in RA, but the data require scientific appraisal into the most clinically and cost-effective strategies.