title: A multidisciplinary and multidimensional intervention for patients with hand osteoarthritis.
abstract: BACKGROUND
  Although several guidelines recommend that treatment programmes in patients with hand osteoarthritis should be both multidisciplinary and multidimensional, currently no such treatment programme for hand osteoarthritis has been described. Therefore the aim of this study was to systematically develop a multidisciplinary and multidimensional non-pharmacological treatment programme and to give a detailed description on the content of this treatment programme.
  The programme was developed in phases. In a preclinical theoretical phase, disease-specific problems, current evidence and the influence of patient characteristics on the benefit of interventions were explored. In a modelling phase, the treatment programme was designed.
  The programme contains an individual intake, four weekly nurse and occupational therapist-led group sessions and a booster session after six months. Treatment components of the programme are self-management, daily home exercises to enhance joint mobility and grip strength and education about ergonomic principles. The treatment programme is tailored to the needs of individual patients with hand osteoarthritis.
  
  
  CONCLUSIONS
  A non-pharmacological multidisciplinary and multidimensional treatment programme for patients with hand osteoarthritis was developed. Further research is necessary to investigate the effectiveness of this treatment programme. Currently, the programme is being evaluated in an ongoing randomized clinical trial.
authors.affiliation: Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. M.Stukstette@maartenskliniek.nl
authors.forename: Mjpm
authors.initials: M
authors.lastname: Stukstette
authors.forename: Tj
authors.initials: T
authors.lastname: Hoogeboom
authors.forename: R
authors.initials: R
authors.lastname: de Ruiter
authors.forename: P
authors.initials: P
authors.lastname: Koelmans
authors.forename: E
authors.initials: E
authors.lastname: Veerman
authors.forename: Aa
authors.initials: A
authors.lastname: den Broeder
authors.forename: H
authors.initials: H
authors.lastname: Cats
authors.forename: Jw
authors.initials: J
authors.lastname: Bijlsma
authors.forename: J
authors.initials: J
authors.lastname: Dekker
authors.forename: Chm
authors.initials: C
authors.lastname: van den Ende
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D018737:Hand Strength; D006801:Humans; D008297:Male; D009426:Netherlands; D010003:Osteoarthritis / Q000175:diagnosis / Q000534:rehabilitation*; D059408:Pain Management; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000379:methods; D026741:Physical Therapy Modalities / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome