PROTOCOL FOR A SCOPING REVIEW TO IDENTIFY SELF-MANAGEMENT SUPPORT INTERVENTIONS DELIVERED VIA TELEHEALTH FOR RHEUMATIC AND MUSCULOSKELETAL DISEASES

ABSTRACT

Background/Aims For some time, there has been an importance placed in rheumatology on promoting and supporting patient self-management. Self-management aims to improve patients' independence and quality of life by empowering individuals to be proactive decision makers while managing their illness. Self-management support (SMS) as detailed in the Practical RevIews in Self-Management Support (PRISMS) taxonomy can include education, monitoring, adherence, training, and support with healthcare practitioner (HCP) interaction. In rheumatic and musculoskeletal diseases (RMDs), interventions for SMS are complex, and have been described by the European League Against Rheumatism (EULAR) as a current unmet need. In response to the COVID-19 pandemic, telerehabilitation has been successfully used at the Royal National Hospital for Rheumatic Diseases in Bath to provide continued SMS to axial spondyloarthritis (axial SpA) patients. Although some research into SMS of inflammatory arthritis has been conducted, there appears to be a scarcity of research on SMS interventions provided through telerehabilitation for axial SpA. The present scoping review aims to systematically identify and describe existing SMS interventions delivered via telehealth for RMDs, and how effectiveness is evaluated within these interventions. Methods The method for a scoping review protocol will be outlined using the JBI manual for evidence synthesis guidance. It is anticipated that there will be a lack of interventions for axial SpA, therefore the broader population of RMDs will be included. Three electronic databases will be searched (Embase, Scopus and Web of Science Core Collection), as well as the reference lists of included full-text studies. A study team of three researchers will apply a priori eligibility criteria, based on the Population (RMDs), Concept (rehabilitation) and Context (telehealth) components of the research focus, to the screening and fulltext screening. Results Data will be extracted into a charting table for relevant full-text articles to allow a narrative synthesis of identified SMS telerehabilitation interventions. We will explore SMS definitions used, aspects of rehabilitation targeted (e.g. education, disease management, psychological support, physical activity, physiotherapy, occupational health input, behaviour change techniques), details on the SMS intervention (e.g. autonomous/group-based, mode of telerehabilitation delivery, length of intervention, synchronous/asynchronous interaction), components of SMS included (PRISMS taxonomy), HCP interaction details, and measures of effectiveness. Conclusion Telehealth, and specifically telerehabilitation, have become a critical feature of healthcare over the last 18 months and may provide an effective long-term solution to broaden provision of SMS for RMDs and improve symptoms, while relieving pressure on healthcare systems. Through this scoping review, existing telehealth delivered SMS interventions for RMDs will be identified, which will help to understand how interventions are currently delivered and effectiveness evaluated in rheumatology. A greater understanding of existing interventions will be critical as we move into the new post-COVID-19 age of blended in-person/ virtual service provision.