title: A randomized clinical trial of in-patient multidisciplinary treatment versus routine out-patient care in active rheumatoid arthritis.
abstract: The aim of the present study was to compare the effects of in-patient multidisciplinary treatment with standard out-patient care in patients with active rheumatoid arthritis (RA). Eighty patients with active RA were randomized to receive 11 days of in-patient multidisciplinary treatment followed by standard out-patient care (n = 39), or to standard out-patient care only (n = 41). Patients were assessed at baseline, and after 2, 4, 12 and 52 weeks. In the in-patients, the improvement in variables of disease activity (weeks 2 and 4) and emotional status (weeks 4 and 12) was greater when compared with the out-patients (P < 0.05). The improvement in laboratory and functional measures did not differ between the groups. In the in-patient group, the percentage of patients responding to the American College of Rheumatology criteria for improvement was significantly greater at any time point during follow-up than in the out-patient group. A short period of in-patient multidisciplinary treatment for active RA has a direct beneficial effect on disease activity and emotional status with the favourable effect on disease activity remaining after 52 weeks.
authors.affiliation: Department of Rheumatology, University Hospital Leiden, The Netherlands.
authors.forename: T P
authors.initials: TP
authors.lastname: Vliet Vlieland
authors.forename: A H
authors.initials: AH
authors.lastname: Zwinderman
authors.forename: J P
authors.initials: JP
authors.lastname: Vandenbroucke
authors.forename: F C
authors.initials: FC
authors.lastname: Breedveld
authors.forename: J M
authors.initials: JM
authors.lastname: Hazes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D003131:Combined Modality Therapy; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors