Outcomes of patients with rheumatoid arthritis receiving rehabilitation.
OBJECTIVE
Rehabilitation, including physical therapy and occupational therapy, complements drug therapy in the management of symptoms in patients with rheumatoid arthritis. Approximately 26% of patients with rheumatoid arthritis receive a referral for rehabilitation by rheumatologists. This review summarizes findings on the effectiveness and economic outcomes of physical therapy and occupational therapy in managing rheumatoid arthritis.


RESULTS
Studies evaluating the outcomes of various service delivery models for physical therapy and occupational therapy demonstrate improvements, especially in physical function, among people with rheumatoid arthritis. A recent pilot study examining the primary therapist model also suggests that the primary therapist model may be a viable option for delivering rheumatoid arthritis rehabilitation services. However, the evidence on other alternative models such as the physical therapy/occupational therapy practitioner model is limited. Only a few economic evaluations have been performed, and among those, none examine the cost-effectiveness of different service models.


CONCLUSIONS
Systematically interpreting the findings of service delivery models in rehabilitation is challenging because of the wide range of interventions and outcome measures used. A thorough understanding of the value of different rehabilitation models will require the guidance of a sound evaluation framework. Future clinical trials should consider including a component for evaluating cost-effectiveness. Such knowledge can contribute to evidence-informed resource allocation.
Li
Linda C
LC
Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada. lli@ohri.ca
Iversen
Maura Daly
MD
D001172:Arthritis, Rheumatoid / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis; D006801:Humans; D009788:Occupational Therapy; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D016896:Treatment Outcome