title: Evaluation of a structured multidisciplinary day care program in rheumatoid arthritis. A similar effect in newly diagnosed and long-standing disease.
abstract: The present study evaluated a multidisciplinary structured day-care programme in patients with rheumatoid arthritis of less than 2 years (n = 41) and more than 2 years disease duration (n = 46). During the 3 week intervention, outcome measures reflecting disability (HAQ, SOFI), the patient's perception of disease and pain (VAS for patient's global assessment and pain), Ritchie articular index (RAI), a 44 swollen joint count, and overall disease activity (DAS) improved significantly in the group as a whole. The improvements remained significant after 15 weeks and were of a similar magnitude in the patient groups with short and long disease duration. At week 3 and 15, the ACR and the EULAR criteria for individual response, for the total study group was fulfilled by 28% and 26%, and 36% and 52% respectively. Evaluation of a subgroup 6 weeks prior to admission indicated that the outcome measures were stable at the time of the intervention. Furthermore, administration of intraarticular glucocorticosteroids (GC) could only partly explain the observed improvement. This uncontrolled observational study supports that a multidisciplinary day-care rehabilitation program is beneficial and feasible for patients with rheumatoid arthritis of both short and long duration.
authors.affiliation: Department of Rheumatology, Malmö University Hospital, Sweden.
authors.forename: L T
authors.initials: LT
authors.lastname: Jacobsson
authors.forename: M
authors.initials: M
authors.lastname: Frithiof
authors.forename: Y
authors.initials: Y
authors.lastname: Olofsson
authors.forename: I
authors.initials: I
authors.lastname: Runesson
authors.forename: B
authors.initials: B
authors.lastname: Strömbeck
authors.forename: I
authors.initials: I
authors.lastname: Wikström
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D003631:Day Care, Medical; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010348:Patient Care Team; D015397:Program Evaluation; D012720:Severity of Illness Index; D016896:Treatment Outcome