CM Borkhoff et al. Reaching those most in need: A scoping review of interventions to improve health care quality for disadvantaged populations with osteoarthritis. Arthritis Care Research, September 14, 2010.

Borkhoff and colleagues conducted a systematic review to identify and describe the scope and nature of the research evidence on the effectiveness of interventions to improve health care quality or reduce disparities in care of disadvantaged populations with osteoarthritis (OA), as an example of a common chronic disease. The group searched electronic databases from 1950 through February 2010 and the literature for relevant articles using any study design. Studies with interventions designed explicitly to improve health care quality or reduce disparities in care of disadvantaged adult populations with OA and including an evaluation were eligible. The investigators used the PROGRESS-Plus framework to identify disadvantaged population subgroups. Of 4,701 citations identified, 10 met the inclusion criteria. Eight were community-based and six targeted race/ethnicity/culture. All 10 studies evaluated interventions aimed at people with OA; 2 studies also targeted the health care system. No studies targeted health care providers. Nine of 10 studies evaluated arthritis self-management interventions; all showed some benefit. Only one study compared the difference in effect between the PROGRESS-Plus disadvantaged population and relevant comparator group.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: There were few studies evaluating the effectiveness of interventions to improve health care quality in disadvantaged populations with OA. Further research is needed to evaluate interventions aimed at health care providers and the health care system, as well as other patient-level interventions.

WHAT THE STUDY MAY MEAN TO AS A HEALTH CARE CONSUMER: It is uncertain what criteria were used in the selection process. Ten out of 4,701 studies suggest they were highly stringent. However, there are an increasing number of community and self-management studies on patients with osteoarthritis so the situation is improving.