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A systematic review of interventions to improve knowledge and self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis

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Abstract

This systematic review aimed to determine the effectiveness of interventions for improving knowledge and/or self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis (RA). We searched four databases (MEDLINE, CINAHL, Cochrane Trials, PsycINFO) using a comprehensive search strategy. Studies were eligible if they were prospective, published in English from 2004 to 2015, included participants with RA and tested an intervention designed to improve knowledge and/or self-management skills relating to family planning, pregnancy or breastfeeding. As no studies met the latter criterion, the search strategy was expanded to include all prospective studies evaluating RA educational and/or self-management interventions. Data on study characteristics, participant characteristics and programme content were extracted to summarise the evidence base for interventions to support people with RA during their reproductive years. Expanded literature searches identified 2290 papers, of which 68 were eligible. Of these, nine papers (13 %) specifically excluded pregnant women/breastfeeding mothers or recruited only older people. Only one study (1 %) explicitly evaluated pregnancy-focused education via a motherhood decision aid, while eight studies (12 %) incorporated relevant (albeit minor) components within broader RA educational or self-management interventions. Of these, three studies provided methotrexate education in relation to conception/pregnancy/breastfeeding; three incorporated discussions on RA and relationships, impact of RA on the family or sexual advice; one provided information regarding contraception and fertility; and one issued a warning regarding use of biologic therapy in pregnancy/breastfeeding. In conclusion, information regarding family planning, pregnancy or breastfeeding represents a negligible part of published RA educational interventions, with scope to develop targeted resources.

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References

  1. Ostensen M, Forger F (2009) Management of RA medications in pregnant patients. Nat Rev Rheumatol 5(7):382–390

    Article  PubMed  Google Scholar 

  2. Chambers CD, Tutuncu ZN, Johnson D, Jones KL (2006) Human pregnancy safety for agents used to treat rheumatoid arthritis: adequacy of available information and strategies for developing post-marketing data. Arthritis Res Ther 8(4):215

    Article  PubMed  PubMed Central  Google Scholar 

  3. Signore C, Spong CY, Krotoski D, Shinowara NL, Blackwell SC (2011) Pregnancy in women with physical disabilities. Obstet Gynecol 117(4):935–947

    Article  PubMed  Google Scholar 

  4. Soh MC, Nelson-Piercy C (2015) High-risk pregnancy and the rheumatologist. Rheumatology 54(4):572–587

    Article  PubMed  Google Scholar 

  5. Cush JJ, Kavanaugh A (2014) Editorial: pregnancy and rheumatoid arthritis - do not let the perfect become the enemy of the good. Curr Opin Rheumatol 26(3):299–301

    Article  PubMed  Google Scholar 

  6. Ngian GS, Briggs AB, Ackerman IN, Van Doornum S (2015) Management of pregnancy in women with rheumatoid arthritis. Med J Aust

  7. Ackerman IN, Jordan JE, Van Doornum S, Ricardo M, Briggs AM (2015) Understanding the information needs of women with rheumatoid arthritis concerning pregnancy, post-natal care and early parenting: a mixed-methods study. BMC Musculoskelet Disord 16:194

    Article  PubMed  PubMed Central  Google Scholar 

  8. Zangi HA, Ndosi M, Adams J, Andersen L, Bode C, Boström C, van Eijk-Hustings Y, Gossec L, Korandová J, Mendes G, Niedermann K, Primdahl J, Stoffer M, Voshaar M, van Tubergen A (2015) EULAR recommendations for patient education for people with inflammatory arthritis. Ann Rheum Dis 74(6):954–962

    Article  PubMed  Google Scholar 

  9. Lorig KR, Holman HR (2003) Self-management education: history, definition, outcomes and mechanisms. Ann Behav Med 26(1):1–7

    Article  PubMed  Google Scholar 

  10. Iversen MD, Hammond A, Betteridge N (2010) Self-management of rheumatic diseases: state of the art and future perspectives. Ann Rheum Dis 69(6):955–963

    Article  PubMed  Google Scholar 

  11. Riemsma RP, Kirwan JR, Taal E, Rasker JJ (2003) Patient education for adults with rheumatoid arthritis. Cochrane Database Syst Rev 2003 (2) Art. No.: CD003688, doi: 10.1002/14651858.CD003688.

  12. Riemsma RP, Taal E, Kirwan JR, Rasker JJ (2004) Systematic review of rheumatoid arthritis patient education. Arthritis Rheum 51(6):1045–1059

    Article  PubMed  Google Scholar 

  13. Albano MG, Giraudet-Le Quintrec JS, Crozet C, d'Ivernois JF (2010) Characteristics and development of therapeutic patient education in rheumatoid arthritis: analysis of the 2003-2008 literature. Joint Bone Spine 77(5):405–410

    Article  PubMed  Google Scholar 

  14. Arthritis Australia (2010) Women’s insights into rheumatoid arthritis. Sydney, Arthritis Australia

    Google Scholar 

  15. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hyrich KL, Verstappen SMM (2014) Biologic therapies and pregnancy: the story so far. Rheumatology 53(8):1377–1385

    Article  PubMed  CAS  Google Scholar 

  17. Giraudet-Le Quintrec J-S, Mayoux-Benhamou A, Ravaud P, Champion K, Dernis E, Zerkak D, Ouslimani A, Courpied J-P, Revel M, Kahan A, Dougados M (2007) Effect of a collective educational program for patients with rheumatoid arthritis: a prospective 12-month randomized controlled trial. J Rheumatol 34(8):1684–1691

    PubMed  Google Scholar 

  18. Mayoux-Benhamou A, Giraudet-Le Quintrec J-S, Ravaud P, Champion K, Dernis E, Zerkak D, Roy C, Kahan A, Revel M, Dougados M (2008) Influence of patient education on exercise compliance in rheumatoid arthritis: a prospective 12-month randomized controlled trial. J Rheumatol 35(2):216–223

    PubMed  Google Scholar 

  19. Homer D, Nightingale P, Jobanputra P (2009) Providing patients with information about disease-modifying anti-rheumatic drugs: individually or in groups? A pilot randomized controlled trial comparing adherence and satisfaction. Musculoskeletal Care 7(2):78–92

    Article  PubMed  Google Scholar 

  20. Li LC, Adam PM, Backman CL, Lineker S, Jones CA, Lacaille D, Townsend AF, Yacyshyn E, Yousefi C, Tugwell P, Leese J, Stacey D (2014) Proof-of-concept study of a web-based methotrexate decision aid for patients with rheumatoid arthritis. Arthritis Care Res 66(10):1472–1481

    Article  CAS  Google Scholar 

  21. Bermas BL (2014) Non-steroidal anti inflammatory drugs, glucocorticoids and disease modifying anti-rheumatic drugs for the management of rheumatoid arthritis before and during pregnancy. Curr Opin Rheumatol 26(3):334–340

    Article  PubMed  CAS  Google Scholar 

  22. Nour K, Laforest S, Gauvin L, Gignac M (2006) Behavior change following a self-management intervention for housebound older adults with arthritis: an experimental study. Int J Behav Nutr Phys Act 3:12

    Article  PubMed  PubMed Central  Google Scholar 

  23. Laforest S, Nour K, Gignac M, Gauvin L, Parisien M, Poirier M (2008) Short-term effects of a self-management intervention on health status of housebound older adults with arthritis. J Appl Gerontol 27(5):539–567

    Article  Google Scholar 

  24. Laforest S, Nour K, Gignac MAM, Gauvin L, Parisien M (2012) The role of social reinforcement in the maintenance of short-term effects after a self-management intervention for frail housebound seniors with arthritis. Can J Aging 31(2):195–207

    Article  PubMed  Google Scholar 

  25. Pariser D, O'Hanlon A (2005) Effects of telephone intervention on arthritis self-efficacy, depression, pain, and fatigue in older adults with arthritis. J Geriatr Phys Ther 28(3):67–73

    Article  PubMed  Google Scholar 

  26. Davis GC, White TL (2008) A goal attainment pain management program for older adults with arthritis. Pain Manag Nurs 9(4):171–179

    Article  PubMed  Google Scholar 

  27. Chui DYY, Lau J, Yau I (2004) An outcome evaluation study of the Rheumatoid Arthritis Self-Management Programme in Hong Kong. Psychol Health Med 9(3):286–292

    Article  Google Scholar 

  28. Siu AMH, Chui DYY (2004) Evaluation of a community rehabilitation service for people with rheumatoid arthritis. Patient Educ Couns 55(1):62–69

    Article  PubMed  Google Scholar 

  29. Glazier RH, Badley EM, Lineker SC, Wilkins AL, Bell MJ (2005) Getting a grip on arthritis: an educational intervention for the diagnosis and treatment of arthritis in primary care. J Rheumatol 32(1):137–142

    PubMed  Google Scholar 

  30. Rapoliene J, Krisciunas A (2006) The effectiveness of occupational therapy in restoring the functional state of hands in rheumatoid arthritis patients. Medicina (Kaunas) 42(10):823–828

    Google Scholar 

  31. Walker D, Adebajo A, Heslop P, Hill J, Firth J, Bishop P, Helliwell PS (2007) Patient education in rheumatoid arthritis: the effectiveness of the ARC booklet and the mind map. Rheumatology 46(10):1593–1596

    Article  PubMed  CAS  Google Scholar 

  32. Osborne RH, Wilson T, Lorig KR, McColl GJ (2007) Does self-management lead to sustainable health benefits in people with arthritis? A 2-year transition study of 452 Australians. J Rheumatol 34(5):1112–1117

    PubMed  Google Scholar 

  33. Mohammad A, Kilcoyne A, Bond U, Regan M, Phelan M (2009) Methotrexate information booklet study 2008. Clin Exp Rheumatol 27(4):649–650

    PubMed  CAS  Google Scholar 

  34. Ellard DR, Barlow JH, Paskins Z, Stapley J, Wild A, Rowe IF (2009) Piloting education days for patients with early rheumatoid arthritis and their partners: a multidisciplinary approach. Musculoskeletal Care 7(1):17–30

    Article  PubMed  CAS  Google Scholar 

  35. Kaariainen M, Kukkurainen ML, Kyngas H, Karppinen L (2011) Improving the quality of rheumatoid arthritis patients’ education using written information. Musculoskeletal Care 9(1):19–24

    Article  PubMed  Google Scholar 

  36. El Miedany Y, El Gaafary M, El Arousy N, Ahmed I, Youssef S, Palmer D (2012) Arthritis education: the integration of patient-reported outcome measures and patient self-management. Clin Exp Rheumatol 30(6):899–904

    PubMed  Google Scholar 

  37. Meade T, Dowswell E, Manolios N, Sharpe L (2015) The motherhood choices decision aid for women with rheumatoid arthritis increases knowledge and reduces decisional conflict: a randomized controlled trial. BMC Musculoskelet Disord 16(1):260

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  38. Meade T, Sharpe L, Aspanell D, Manolios N. Motherhood choices: a decision aid for women with rheumatoid arthritis. Available from: http://arthritisnsw.org.au/arthritis/research/ra-and-motherhood/; accessed 27 October 2015

  39. Fraenkel L, Peters E, Charpentier P, Olsen B, Errante L, Schoen RT, Reyna V (2012) Decision tool to improve the quality of care in rheumatoid arthritis. Arthritis Care Res 64(7):977–985

    Google Scholar 

  40. Ciciriello S, Buchbinder R, Osborne RH, Wicks IP (2014) Improving treatment with methotrexate in rheumatoid arthritis-development of a multimedia patient education program and the MiRAK, a new instrument to evaluate methotrexate-related knowledge. Semin Arthritis Rheum 43(4):437–446

    Article  PubMed  CAS  Google Scholar 

  41. Hammond A, Young A, Kidao R (2004) A randomised controlled trial of occupational therapy for people with early rheumatoid arthritis. Ann Rheum Dis 63(1):23–30

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  42. Hammond A, Bryan J, Hardy A (2008) Effects of a modular behavioural arthritis education programme: a pragmatic parallel-group randomized controlled trial. Rheumatology 47(11):1712–1718

    Article  PubMed  CAS  Google Scholar 

  43. Horne R, Hankins M, Jenkins R (2001) The Satisfaction with Information about Medicines Scale (SIMS): a new measurement tool for audit and research. Qual Health Care 10(3):135–140

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  44. Stacey D, Légaré F, Col Nananda F, Bennett Carol L, Barry Michael J, Eden Karen B, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L, Wu Julie HC (2014) Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev (1) Art. No.: CD001431. DOI: 10.1002/14651858.CD001431.pub4

  45. Meade T, Sharpe L, Hallab L, Aspanell D, Manolios N (2013) Navigating motherhood choices in the context of rheumatoid arthritis: women’s stories. Musculoskeletal Care 11(2):73–82

    Article  PubMed  CAS  Google Scholar 

  46. Ndosi M, Bremander A, Hamnes B, Horton M, Kukkurainen ML, Machado P, Marques A, Meesters J, Stamm TA, Tennant A, de la Torre-Aboki J, Vliet Vlieland TPM, Zangi HA, Hill J (2013) Validation of the educational needs assessment tool as a generic instrument for rheumatic diseases in seven European countries. Ann Rheum Dis 73(2122-9)

  47. Kavanaugh A, Cush JJ, Ahmed MS, Bermas BL, Chakravarty E, Chambers C, Clowse M, Curtis JR, Dao K, Hankins GD, Koren G, Kim SC, Lapteva L, Mahadevan U, Moore T, Nolan M, Ren Z, Sammaritano LR, Seymour S, Weisman MH (2015) Proceedings from the American College of Rheumatology Reproductive Health Summit: the management of fertility, pregnancy, and lactation in women with autoimmune and systemic inflammatory diseases. Arthritis Care Res 67(3):313–325

    Article  Google Scholar 

  48. Ostensen M (2014) Contraception and pregnancy counselling in rheumatoid arthritis. Curr Opin Rheumatol 26(3):302–307

    Article  PubMed  Google Scholar 

  49. O'Neill C, Ngian G, Nicholson P, Van Doornum S (2015) Contraceptive use in women with rheumatologic disease taking disease modifying anti-rheumatic drugs. Intern Med J 45(2):44

    Google Scholar 

  50. Dalkilic E, Tufan AN, Oksuz MF, Sahbazlar M, Coskun BN, Seniz N, Pehlivan Y, Inanc M (2014) Comparing female-based contraceptive methods in patients with systemic lupus erythematosus, rheumatoid arthritis and a healthy population. Int J Rheum Dis 17(6):653–657

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Melbourne EpiCentre, The University of Melbourne and Melbourne Health, Melbourne, Australia

    Ilana N. Ackerman, Gene-Siew Ngian & Sharon Van Doornum

  2. Arthritis and Osteoporosis Victoria, Melbourne, Australia

    Andrew M. Briggs

  3. Curtin University, Perth, Australia

    Andrew M. Briggs

  4. Royal Melbourne Hospital, 7 East, Main Block, Parkville, Victoria, 3050, Australia

    Ilana N. Ackerman, Gene-Siew Ngian & Sharon Van Doornum

Authors
  1. Ilana N. Ackerman
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  2. Gene-Siew Ngian
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  3. Sharon Van Doornum
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  4. Andrew M. Briggs
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Correspondence to Ilana N. Ackerman.

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Funding

This study was supported by unrestricted grant-in-aid funding from AbbVie, Janssen and UCB, with in-kind support from Arthritis and Osteoporosis Victoria. Dr Ackerman is supported by a National Health and Medical Research Council of Australia Public Health (Australian) Early Career Fellowship (#520004). The study sponsors had no role in the study design, collection, analysis and interpretation of data, in the writing of the manuscript or in the decision to submit the manuscript for publication.

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Ackerman, I.N., Ngian, GS., Van Doornum, S. et al. A systematic review of interventions to improve knowledge and self-management skills concerning contraception, pregnancy and breastfeeding in people with rheumatoid arthritis. Clin Rheumatol 35, 33–41 (2016). https://doi.org/10.1007/s10067-015-3131-7

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  • DOI: https://doi.org/10.1007/s10067-015-3131-7

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