Support needs and non-pharmacological interventions for adults with mixed connective tissue disease: a systematic literature review

Objectives: The objective of this study was to systematically review and assess the quality of the evidence regarding (1) the need for non-pharmacological support of adult patients with mixed connective tissue disease (MCTD) and (2) the elements of non-pharmacological interventions delivered to patients with MCTD. Methods: A systematic literature search was conducted in August 2024 across 4 databases: Embase, CINAHL, CENTRAL, and Medline, using diverse terminologies for MCTD. The quality of the selected studies was assessed with the Critical Appraisal Skills Programme tools for qualitative and case-control studies, and results were summarised narratively. The study protocol was preregistered with PROSPERO (ID: CRD42024591268). Results: The search yielded 7091 unique records, with 4 articles meeting the inclusion criteria after screening. Three studies with varying quality assessments (1 low and 2 high) identified patient support needs across 3 domains: educational, mental health, and pregnancy-related needs. A fourth study, found to be of low quality, assessed a non-pharmacological intervention, specifically a tandem-psychotherapy approach. Conclusions: This review with a narrative synthesis highlights a significant gap in high-quality evidence regarding non-pharmacological support for patients with MCTD. It underscores the urgent need for further research to better understand and address the non-pharmacological needs of this population, facilitating the development of effective interventions for managing the complexity of MCTD.