title: Effects of disease management programs on functional status of patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To perform a systematic review of the published literature on disease management of rheumatoid arthritis (RA) and to use meta-analysis to estimate the magnitude of benefit these programs have on functional status in patients with RA.
  
  
  METHODS
  Computerized databases for English articles from 1966 to September 2001 were searched. Two reviewers evaluated 1,029 published titles, identified 11 studies meeting explicit inclusion criteria, and extracted data about study characteristics, interventions used, and outcomes measured. Pooled effect sizes for functional status were calculated using a random-effects model.
  
  
  RESULTS
  Four out of 8 disease management programs showed significant improvements in functional status; however, the pooled effect size (ES) was small and statistically non-significant (ES 0.27; 95% confidence interval [95% CI] -0.01, 0.54). Studies with longer intervention durations (>5 weeks) had significantly improved patient functional status (ES 0.49; 95% CI 0.12, 0.86), compared with studies with shorter intervention durations (</=5 weeks, ES 0.13; 95% CI -0.25, 0.52).
  
  
  CONCLUSIONS
  There were limited data to support or refute the effectiveness of disease management programs in improving functional status in patients with RA. Additional studies are needed to confirm if a more intensive intervention may be of benefit to patients with RA, as suggested by our study.
authors.affiliation: Zynx Health Incorporated, Los Angeles, California, USA.
authors.forename: Enkhe
authors.initials: E
authors.lastname: Badamgarav
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Croft
authors.forename: Andriana
authors.initials: A
authors.lastname: Hohlbauch
authors.forename: James S
authors.initials: JS
authors.lastname: Louie
authors.forename: James
authors.initials: J
authors.lastname: O'Dell
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Ofman
authors.forename: Maria E
authors.initials: ME
authors.lastname: Suarez-Almazor
authors.forename: Arthur
authors.initials: A
authors.lastname: Weaver
authors.forename: Patience
authors.initials: P
authors.lastname: White
authors.forename: Paul
authors.initials: P
authors.lastname: Katz
mesh_terms: D001172:Arthritis, Rheumatoid / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D016896:Treatment Outcome