Experts prioritize osteoarthritis non-surgical interventions from Cochrane systematic reviews for translation into “Evidence4Equity” summaries

Abstract

Objective Osteoarthritis generates substantial health and socioeconomic burden, which is particularly marked in marginalized groups. It is imperative that practitioners have ready access to summaries of evidence-based interventions for osteoarthritis that incorporate equity considerations. Summaries of systematic reviews can provide this. The present study surveyed experts to prioritize a selection ofinterventions, from which equity focused summaries will be generated. Specifically, the prioritized interventions will be developed into Cochrane Evidence4Equity (E4E) summaries. Methods Twenty-seven systematic reviews of OA interventions were found. From these, twenty-nine non-surgical treatments for osteoarthritis were identified, based on statistically significant findings for desired outcome variables or adverse events. Key findings from these studies were summarised and provided to 9 experts in the field of osteoarthritis.. Expert participants were asked to rate interventions based on feasibility, health system effects, universality, impact on inequities, and priority for translation into equity based E4E summaries. Expert participants were also encouraged to make comments to provide context for each rating. Free text responses were coded inductively and grouped into subthemes and themes. Results Expert participants rated the intervention home land-based exercise for knee OA highest for priority for translation into an E4E summaries, followed by the interventions individual land-based exercise for knee OA, class land-based exercise for knee OA, exercise for hand OA and land-based exercise for hip OA. Upon qualitative analysis of the expert participants’ comments, fifteen subthemes were identified and grouped into three overall themes: (1) this intervention or an aspect of this intervention is unnecessary or unsafe; (2) this intervention or an aspect of this intervention may increase health inequities; and (3) experts noted difficulties completing rating exercise. Conclusion The list of priority interventions and corresponding expert commentary generated information that will be used to direct and support knowledge translation efforts.

Remotely Delivered Exercise to Rural Older Adults With Knee Osteoarthritis: A Pilot Study

“…The CDC and other groups have recognized the need to improve equity in access to and delivery of evidence‐based OA management programs ( 6 ). A recent study found that experts rated land‐based home exercise the highest priority intervention for knowledge translation and dissemination to help decrease disparities in knee OA and improve outcomes in underserved populations, including rural communities ( 47 ). Given the results of the current study, remote delivery of EF classes is a promising intervention to address environmental barriers to exercise participation ( 10 ) and reduce the high burden of OA in the rural population ( 13 ).…”