# The self-management support needs of people diagnosed with psoriatic arthritis: a realist review protocol

## TL;DR

This study aims to identify effective ways healthcare professionals can support people with psoriatic arthritis in managing their condition.

## Contribution

The study introduces a realist review protocol to explore self-management support strategies for psoriatic arthritis patients.

## Key findings

- A theoretical framework with nine initial programme theories was developed and refined with patient and public input.
- A systematic search strategy across multiple databases will be used to gather evidence on self-management support.
- Data synthesis will refine programme theories to explain effective support for psoriatic arthritis patients.

## Abstract

Psoriatic arthritis (PsA) is a form of inflammatory arthritis linked to psoriasis. Previous research from the UK has found that many people feel unsupported when diagnosed with PsA and lack confidence in managing their condition. This realist review aims to understand what works and does not work for whom and in what circumstances, in relation to healthcare professionals engaging with people to support them in developing self-management skills.

This protocol was developed by defining the scope of the review, using a brief directed literature review to support discussion by an expert group of researchers, healthcare professionals and a patient partner. A theoretical domains framework was generated, consisting of nine initial programme theories. These were further refined with input from Patient and Public Involvement and Engagement groups and used to develop a database search strategy.

A systematic search of MEDLINE, CINAHL, Embase, Emcare and APA PsycINFO will be carried out, supplemented by citation tracking, exploration of grey literature and a mixed methods survey of rheumatology health professionals. Data selection will be performed by a minimum of two reviewers and data from included sources will be extracted using a template. Data will be synthesised narratively with respect to the identified initial programme theories, using these data to refine or refute these theories. This will generate refined programme theories to explain what works for whom and in what circumstances.

Ethical approval for the health professionals survey was granted through the Research Ethics Committee, University of the West of England (Project ID: 10991848). Outputs will be disseminated to the research community through conference presentations and a peer-reviewed journal article. The strategy for sharing outputs with patients and health professionals will be discussed and agreed with knowledge user groups.