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 literature search, covering 2009 up to December 2013. Selective review of current literature was produced by searching for 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 of cognitive behavioural therapy and psychotherapeutic intervention, selfmanagement, and physical therapy (exercise), but a few studies indicated a beneficial effect of the multi-disciplinary education programme and specific dietary interventions. The evidence of effectiveness varies among the different non-pharmacological modalities and indicates a need for further investigation into the most clinical and cost-effective strategies to deliver individual, non-pharmacological treatment modalities, as well as comprehensive arthritis service delivery models for patients with RA.

Conclusion: This article gives a summary of the available evidence regarding the effectiveness 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.