Lay Health Worker Interventions in Rheumatology: A Scoping Review.
Review
Overview
abstract
OBJECTIVE: To determine next steps for lay health worker (LHW) intervention research, specifically in patients with rheumatic musculoskeletal diseases (RMD), there is a need to establish what strategies have been effective for chronic disease management thus far. The goal of this scoping review is to collate the literature of LHW interventions for adults with RMD to inform next steps for LHW research. METHODS: A comprehensive literature search was performed in the following databases from inception - September 2021: Ovid MEDLINE, Ovid EMBASE, CINAHL, PsycINFO and The Cochrane Library. Studies retrieved were then screened for eligibility against predefined inclusion/exclusion criteria. RESULTS: Twenty-two articles were eligible and included in this review. The most common RMD studied diseases, not mutually exclusive, were osteoarthritis (n=13), rheumatoid arthritis (n=9), and unspecified/other RMD (n=14). Most studies had a homogenous patient population enrolling White, non-Hispanic or Latina females over the age of sixty (n=13). Eight studies observed statistically significant results in the intervention arm compared to the control. Only one of these studies exhibited sustained treatment effects past one year. CONCLUSION: There are not enough data to conclude if LHW interventions have a positive, null, or negative effect in patients with RMD. Future LHW interventions should specify a priori hypotheses, be powered to detect statistical significance for primary outcomes, employ a theoretical framework, include an active control, describe training protocols for LHW, and increase minority representation, in order to establish the effectiveness of LHW for patients with RMD.
