Strategies to Improve Equitable Access to Early Osteoarthritis Diagnosis and Management: An updated Review

Abstract

Though osteoarthritis (OA) affects millions of people worldwide, many fail to access recommended early, person-centered OA care, particularly women who are disproportionately impacted by OA. A prior review identified few strategies to improve equitable access to early diagnosis and management for multiple disadvantaged groups. We aimed to update that review with literature published in 2010 or later on strategies to improve OA care for disadvantaged groups including women. We identified only 11 eligible studies, of which only 2 (18%) focused on women only. Other disadvantaged groups targeted in the largely US-based studies included patients who are Black, Spanish-speaking, rural, and adults aged 60 years and older. All studies evaluated interventions targeted to patients; 4 (36%) assessed video decision aids, and 7 (63.6%) assessed in-person, video, or telephone self-management education. Interventions were often multifaceted (n = 9, 82%), and most studies (n = 8, 73%) achieved positive outcomes in at least some outcomes measured. No studies evaluated clinician- or system-level strategies. Few studies (n = 5, 45%) described how they tailored strategies to disadvantaged groups or how they addressed person-centered care concepts apart from enabling self-management. Future research is needed to develop, implement, evaluate, and scale-up multilevel strategies to enhance equitable, person-centered OA care for disadvantaged groups including women.