Self-management interventions in systemic sclerosis: A systematic review.

Area of Science:

• Rheumatology and Autoimmune Diseases
• Patient Self-Management Science
• Evidence Synthesis and Systematic Review Methodology

Background:

• Systemic sclerosis is a rare, incurable autoimmune disease requiring significant patient self-management.
• A systematic evaluation of self-management interventions and outcomes is crucial for advancing care.
• Current understanding of effective self-management strategies for systemic sclerosis remains limited.

Purpose of the Study:

• To systematically identify and describe self-management interventions for adults with systemic sclerosis.
• To evaluate the impact of these interventions on key self-management outcomes.
• To assess the current state of scientific evidence regarding self-management in systemic sclerosis.

Main Methods:

• Systematic literature search of PubMed, CINAHL, and Embase databases up to March 2020.
• Inclusion criteria: self-management intervention, National Institute of Nursing Research common data elements (patient activation, self-efficacy, self-regulation, global health), and adult systemic sclerosis population.
• Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

Main Results:

• 16 studies met the inclusion criteria from an initial 215 identified.
• Significant variability observed in the types of self-management interventions and their reported effects.
• Rehabilitation programs targeting physical function were the most common intervention type (n=7).

Conclusions:

• The methodological quality of existing studies is generally poor, hindering robust synthesis and recommendations.
• Further research with larger, rigorously designed studies is needed to advance the science of self-management in systemic sclerosis.
• Future studies must incorporate key self-management outcomes to enable comparative analysis and evidence-based practice.