Effectiveness of the primary therapist model for rheumatoid arthritis rehabilitation: a randomized controlled trial.
OBJECTIVE
To compare the primary therapist model (PTM), provided by a single rheumatology-trained primary therapist, with the traditional treatment model (TTM), provided by a physical therapy (PT) and/or occupational therapy (OT) generalist, for treating patients with rheumatoid arthritis (RA).


METHODS
Eligible patients were adults requiring rehabilitation treatment who had not received PT/OT in the past 2 years. Participants were randomized to the PTM or TTM group. The primary outcome was defined as the proportion of clinical responders who experienced a > or =20% improvement in 2 of the following measures from baseline to 6 months: Health Assessment Questionnaire, pain visual analog scale, and Arthritis Community Research and Evaluation Unit RA Knowledge Questionnaire.


RESULTS
Of 144 consenting patients, 33 (10 PTM participants, 23 TTM participants) dropped out without completing any followup assessment, leaving 111 for analysis (63 PTM participants, 48 TTM participants). The majority were women (PTM 87.3%, TTM 79.2%), with a mean age of 54.2 years and 56.8 years for the PTM and TTM groups, respectively. Average disease duration was 10.6 years and 13.2 years for each group, respectively. At 6 months, 44.4% of patients in the PTM group were clinical responders versus 18.8% in the TTM group (chi(2) = 8.09, P = 0.004).


CONCLUSIONS
Compared with the TTM, the PTM was associated with better outcomes in patients with RA. The results, however, should be interpreted with caution due to the high dropout rate in the TTM group.
Li
Linda C
LC
Ottawa Health Research Institute, Clinical Epidemiology Program, 1053 Carling Avenue, Administration Building Rm. #2-014, Ottawa, Ontario K1Y 4E9, Canada. lli@ohri.ca
Davis
Aileen M
AM
Lineker
Sydney C
SC
Coyte
Peter C
PC
Bombardier
Claire
C
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000534:rehabilitation* / Q000628:therapy; D019090:Case Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000458:organization & administration*; D009864:Ontario; D010348:Patient Care Team / Q000458:organization & administration; D017060:Patient Satisfaction; D026761:Physical Therapy Specialty / Q000458:organization & administration*; D011788:Quality of Life; D012219:Rheumatology / Q000458:organization & administration*; D016896:Treatment Outcome