Behaviour change interventions for the management of Raynaud’s phenomenon: a systematic literature review

Abstract

ObjectivesRaynaud’s phenomenon (RP) is a significant cause of morbidity. Vasodilator medications cause unwanted adverse effects, with behavioural and lifestyle changes forming the mainstay of self-management; this is difficult to implement successfully. The objectives of this study were to evaluate the efficacy of behaviour change interventions for RP and identify learning points for future treatment development.DesignSystematic literature review and narrative synthesis of findings.Data sourcesEMBASE, MEDLINE, Cochrane and PsycINFO were searched for eligible studies on 22 August 2017.Eligibility criteriaRandomised controlled trials (RCTs) of behaviour change interventions with at least one control comparator arm.Data extraction and synthesisStudy selection, data extraction and risk of bias were assessed independently by two reviewers, reaching consensus with a third when necessary. Primary outcomes of interest included severity/impact, frequency and duration of RP episodes, pain, disability, adverse events and study withdrawal.ResultsOf 638 articles retrieved, eight studies fulfilled criteria for inclusion. Biofeedback was the active behaviour change treatment arm for seven studies, with one study reporting a behavioural intervention. Studies were published 1978–2002; six were USA-based studies, one German and one Swedish. Using Cochrane Risk of Bias assessment, studies were assessed to be overall at high risk of bias, with the exception of one large RCT. The total sample included 495 participants (study median=29), with a median age of 39.5 years and preponderance towards females (73%). Five studies reported significant effects in primary outcomes of interest; however, due to missing data, relative efficacy of interventions could not be reliably assessed.ConclusionsThere is no evidence to support or refute claims of the efficacy of behaviour change interventions for the management of RP. There remains a strong case for developing and testing behaviour change interventions that focus on self-management; however, theoretical development and advancement in trial quality is imperative to underpin future work.PROSPERO registration numberCRD42017049643.

Efficacy analysis of minimally invasive surgery for Raynaud’s syndrome

“…The patients were given behavioral interventions before discharge and were instructed to pay attention to keeping their digits warm and avoiding cold exposure. Although there was little evidence demonstrating that daily lifestyle habits influenced RS pathogenesis [ 10 , 11 ], patients should be encouraged to quit smoking to promote vasoconstriction [ 10 ].…”

Factors Influencing Patient Decision‐Making Concerning Treatment Escalation in Raynaud’s Phenomenon Secondary to Systemic Sclerosis

“…This is of interest because experts from the Scleroderma Clinical Trials Consortium and the Canadian Scleroderma Research Group, in general, propose an additive approach (with drugs used in combination) for the treatment of SSc-RP (9). Onethird (29.7%) of patients also indicated that they are keen to consider nonpharmacologic approaches to management, although the evidence base to support these interventions at present are limited (18).…”

Raynaud-szindróma, 2024

“…A vizsgálatok többsége az 1980-90-es években készült, és a leggyakrabban 'biofeedback' készülékeket alkalmaztak, amelyeket esetenként kombináltak autogén tréninggel. A vizsgálatok vegyes eredménnyel zárultak, és nem tekinthetők konkluzívnak [57,58]. Annak ellenére, hogy a Raynaudszindróma kezelésében az elsődleges az életvezetési tanácsadás, az utóbbi 10-20 évben nem történt olyan kutatás, amely pszichológiai szintű segítségnyújtás bármilyen módszerének hatékonyságát vizsgálta volna.…”

“…Annak ellenére, hogy a Raynaudszindróma kezelésében az elsődleges az életvezetési tanácsadás, az utóbbi 10-20 évben nem történt olyan kutatás, amely pszichológiai szintű segítségnyújtás bármilyen módszerének hatékonyságát vizsgálta volna. Egy új áttekintő tanulmányban [58] számos fontos javaslatot tesznek a további vizsgálatok számára. Kiemelik: fontos, hogy a vizsgálat megfelelő konceptuális kerettel rendelkezzen, a legfrissebb diagnosztikus kritériumokat alkalmazzák, az elsődleges és a másodlagos kórforma külön legyen kezelve, objektív és szubjektív (például önkitöltős kérdőív) mérés egyaránt történjen, a vizsgálatvezető elvárásai ne befolyásolhassák az eredményt, és megfelelő elemszámú randomizált, kontrollált mintákkal történjen a vizsgálat.…”