Self-management education programs (SMEPs) for adults with coexisting overweight or obesity and knee osteoarthritis: A systematic review.

Abstract

<h4>Objective</h4>This review aimed to synthesize the content and delivery of SMEPs and explore outcomes improvement (pain, knee function, weight loss, and quality of life) in adults with overweight/obesity and KOA across RCTs, non-RCTs, and cohorts.<h4>Methods</h4>A systematic search of multiple databases and grey literature (Google Scholar) was conducted using combinations of terms ('self-management education program,' 'knee osteoarthritis,' 'obesity,' 'overweight') with Boolean operators and MeSH terms. Eligible studies included adults with overweight/obesity and KOA, evaluating SMEPs via RCTs, non-RCTs, or prospective cohorts with self-reported or performance outcomes. Two reviewers independently screened the studies, with a third reviewer resolving any conflicts. Methodological quality was assessed using MQCAT. Results were synthesized narratively using thematic analysis.<h4>Results</h4>Sixteen studies met the inclusion criteria with moderate to high MQCAT scores (10-13/14). SMEPs commonly included symptom management, exercise, weight-management, pacing, and additional strategies such as communication skills and joint protection. Most were group-based (n = 14), delivered in mixed formats (n = 11) by healthcare professionals, <8 weeks in duration (n = 7). The majority were facility-based (n = 9) and conducted primarily in the U.S. SMEPs improved multiple outcomes, particularly pain.<h4>Conclusion</h4>This review provides novel insights into SMEPs' content and delivery for adults with overweight/obesity and KOA, a group not previously examined. Findings support tailored, multidisciplinary programs integrating exercise, weight-management, and psychosocial support, which clinicians can implement through coordinated care and policymakers may scale within community services. However, few studies targeted this group. Future SMEPs require stratified RCTs, standardized outcomes, and cost-effectiveness evaluations.