[Results of a randomised controlled trial on the acceptance and the outcomes of a counselling on medical inpatient rehabilitation in gainfully employed members of statutory health insurances with rheumatoid arthritis (clinicaltrials.gov identifier NCT00229541)].
OBJECTIVE
In a randomised controlled trial we examined the influence of a counselling (and implementation) of an inpatient rehabilitation programme on the somatic, mental and sociomedical course of rheumatoid arthritis (RA) in employees. Additionally, the recruitment of a study population via routine data of statutory health insurances was tested.


METHODS
Potential study participants were identified by health insurances via RA-specific data on work disability, hospital stays and medical prescriptions. These insurants entered a two-stage selection process (postal screening questionnaire, experts). Eligible participants completed a postal questionnaire on their subjective health status, the responders were randomised into intervention group (IG) and control group (CG), respectively. The IG was offered a counselling on medical rehabilitation, CG members received usual care. Pension funds and health insurances transferred data on sick leaves (cases, days), hospital treatment, disability pension and medical rehabilitation (primary outcomes). Twelve months after baseline, again a questionnaire on subjective health status was completed (secondary outcomes). Data were analysed on an intention to treat and as actual basis.


RESULTS
Whilst the offered counselling was accepted very well (IG: 84.4%), the attendance in a medical inpatient rehabilitation was low (IG: 31.3%). Neither an intention to treat analysis (IG vs. CG) nor an as actual analysis (rehabilitation vs. no rehabilitation) perceived significant differences in the course of sick leave, hospital treatment or parameters of subjective health.


CONCLUSIONS
The study showed the feasibility of a randomised controlled trial in rehabilitation-related Health Services Research. Recruitment via routine data of health insurances showed limitations. The low acceptance of a medical inpatient rehabilitation emphasises the need to establish alternative rehabilitative programs focussing on employed RA patients.
Schlademann
S
S
Institut für Sozialmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Beckergrube 43-47, Lübeck, Germany. susanne.schlademann@uk-sh.de
Hüppe
A
A
Raspe
H
H
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000534:rehabilitation*; D003376:Counseling / Q000706:statistics & numerical data*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*