ASSISTIVE TECHNOLOGY FOR RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW

Background: Provision of assistive technology is a widely used intervention for persons with rheumatoid arthritis. Yet, there is very limited research on the effectiveness of assistive technology in this population. Objectives: To assess the benefits of assistive technology for adults with rheumatoid arthritis in terms of improving functional ability and reducing pain, and to assess potential adverse effects in terms of psychological discomfort, personal injury or material damage related to devise use. Methods: An extensive systematic literature search was performed for articles published in Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, ISI Web of Science, PEDro and OTseeker, searching for randomised controlled trials, clinical controlled trials, controlled before and after studies, interrupted time series and comparative observational studies if addressing adverse effects. In addition, we scanned reference lists, sought grey literature and had personal communication with authors. The search results were screened applying predefined inclusion and exclusion criteria. Results: A total of 13 studies were retrieved in full text, of which 12 were excluded, either due to study design (n=11) or participants' characteristics' (n=1). One clinical controlled trial with 29 participants was included in the review. The study compared the use of an eye drop delivery device to a standard bottle in persons with rheumatoid arthritis suffering from persistent dry eyes. The study results gives moderate evidence that use of the eye drop delivery device improves the ability squeeze out drops, aim drops, control the number of drops, and prevents adverse effects. The results also demonstrate that there is a lack of high quality research on the effectiveness of assistive technology. Future studies should concentrate on investigating devices with moderate or high costs where effects are uncertain or moderate. Effect of large and costly devices should be tested one at the time, while minor assistive devices can be handled and tested as a group if they are homogenous regarding potential outcomes. If a randomized controlled trial is difficult to perform due to ethical or practical circumstances, the n-of-1 RCT can be a good alternative. Patient populations should be homogeneous, and care should be taken to ensure a close correspondence between the purpose of using a device, and the outcome measure(s) used to test the effect of the device. Conclusion: There is very limited evidence for the effect of assistive technology for adults with rheumatoid arthritis. Thus, there is a need for high-quality research addressing the effectiveness of assistive technology in this population. Disclosure of Interest: None declaredCitation: Annals of the Rheumatic Diseases, volume 68, supplement 3, year 2009, page 787Session: Occupational therapy (Poster Presentations )