E52. EFFECTS OF WEB-BASED INTERVENTIONS ON PHYSICAL FUNCTION AND ACTIVITY, PAIN AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW

Abstract

Background: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder of the joints which affects approximately 1% of the UK population. Web-based health care interventions have the potential to reach a greater number of people at a low cost and which can be accessed at user convenience. What are the benefits and harms of web-based rehabilitation interventions on pain, function and quality of life in adults with rheumatoid arthritis? Methods: We searched electronic databases for randomized controlled trials published till July 2016 in peer-reviewed journals in English. Two independent authors performed study selection, data extraction and methodological quality rating using the Cochrane Risk of Bias (RoB) tool. Results: We found four trials (n=565 participants with RA), of which two focused on web-based self-management, and two on physical activity interventions. Inconsistent results (positive or no differences) were seen for pain (two studies: self-management) and quality of life (two studies: self-management and physical activity) that evaluated these outcomes. Three studies (two self-management; one physical activity) evaluated function and reported no significant differences between groups. None of the studies reported adverse events. We were not able to conduct a meta-analysis mainly due to the insufficient reporting of data. Conclusion: All studies were of small sample size (≥ 100 in intervention group) and at low risk of bias for attrition and selective reporting. Summary risk of bias assessments across Cochrane RoB domains were high for studies that focused on web-based physical activity and unclear for self-management interventions.We found inconsistent results for pain and quality of life, and no effects on function. Harmful effects of web-based interventions are unknown. More high quality trials are urgently needed to address some significant gaps identified in the current evidence base such as lack of large sample sizes, adequate reporting of data, standardized outcome measures, theory-informed interventions, and inclusion of generalizable RA population.