Persistent functional and social benefit 5 years after a multidisciplinary arthritis training program.
OBJECTIVE
To assess the sustainable benefits of a professional, multidisciplinary training program for patients with rheumatoid arthritis.


METHODS
Two studies with different observation periods. Study I was a prospective, randomized trial for 1 year. Study II was a noncontrolled observation over 5 years.


METHODS
The 9-day program for eight patient groups encompassed a multidisciplinary cooperation between rheumatologists, orthopedists, physicotherapists, psychologists and social workers.


METHODS
Sixty-eight consecutive patients with rheumatoid arthritis participated in an arthritis training program either immediately after enrollment in the program or after 1 year.


METHODS
The program covered the following fields: pathogenesis of rheumatoid arthritis, drug therapy, physicotherapy, practical exercise in remedial gymnastics, use of joint protection devices, orthopedic perspectives, psychological counseling, dietetics, information about unproven cures and social assistance.


METHODS
Clinical outcome was assessed by self-report questionnaires: (1) Stanford Health Assessment Questionnaire, (2) Freiburg Questionnaire of Coping with Illness, (3) Beck Depression Inventory, and (4) a 21-point scale to evaluate cognitive-behavioral and environmental impact.


RESULTS
A significant and persistent improvement of all investigated parameters was demonstrated in the 1-year controlled trial. Between the end-point of the 1-year study and the 5-year evaluation, this improvement increased even more for functional status and coping with illness, whereas depression returned to baseline values. These effects were seen even without reinforcement of the training.


CONCLUSIONS
A professional, multidisciplinary approach to educate patients with rheumatoid arthritis leads to a significant and sustained improvement of the clinical outcome and is an approach that should be established as a part of conventional therapy.
Scholten
C
C
Department of Internal Medicine II, University of Vienna Medical School, Austria.
Brodowicz
T
T
Graninger
W
W
Gardavsky
I
I
Pils
K
K
Pesau
B
B
Eggl-Tyl
E
E
Wanivenhaus
A
A
Zielinski
C C
CC
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000517:prevention & control / Q000523:psychology* / Q000534:rehabilitation*; D018592:Cross-Over Studies; D003863:Depression / Q000209:etiology / Q000517:prevention & control*; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration*; D015397:Program Evaluation; D011446:Prospective Studies; D012648:Self Care / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires