Utilization of Rehabilitation Services Among People With Common Autoimmune Rheumatic Diseases: A Systematic Review.

Abstract

Rehabilitation services, including physical and occupational therapy, are frequently recommended in the management of many autoimmune rheumatic diseases (ARDs), yet utilization remains unclear. This systematic review aimed to evaluate how frequently people with common ARDs utilize rehabilitation services. We conducted a systematic review of studies published through December 2023 that reported rehabilitation utilization (percentage utilization and/or number of visits) among individuals with ARDs. PubMed and CINAHL were searched. Two reviewers independently screened studies, and data were extracted and summarized by disease, discipline, reporting period, and country. Of 11,591 records identified, 113 studies met inclusion criteria, and 86 were included in the final analysis. These studies were published between 1991 and 2023, with data representing 22 countries. Rehabilitation utilization was most frequently reported for rheumatoid arthritis (n = 59), axial spondyloarthritis (n = 25), and systemic sclerosis (n = 20). Percentage utilization rates ranged from 0% to 100%, and annual visit counts ranged from 1 to 62.1, varying widely across and within disease types, reporting periods, and countries. Physical therapy was more commonly reported and utilized than occupational therapy. Utilization rates were generally higher in European countries compared to North America. There was heterogeneity across studies underscoring wide variability in the use of rehabilitation services. These findings highlight inconsistent integration of rehabilitation into rheumatology care across diseases and health systems. Future research should investigate current barriers and facilitators and inform the development of systematic, equitable, and disease-specific strategies to optimize access and delivery of rehabilitation for people with ARDs.