title: Epidemiological evaluation quality of life in patients suffering from early rheumatoid arthritis: a pragmatic, prospective, randomized, blind allocation controlled of a modular program group intervention.
abstract: OBJECTIVE
  Epidemiology has taken on new roles in the management of health care services. In this study, we developed a non-pharmacological self-management modular program group intervention and evaluated its efficacy as an adjunct therapy in patients suffering from early rheumatoid arthritis (RA).
  
  
  METHODS
  Patients were randomized to either participate in a non-equivalent intervention group along with the standard of care or only receive standard-of-care treatment at a community rheumatology center. The outcomes measured were a pain visual analog scale (VAS), patient general health (GH) on a VAS, and the Short Form 36 Health Survey version 2 scale measuring quality of life. These parameters were evaluated in the first week to obtain baseline values, and at 20, 32, 48, and 60 weeks to evaluate the efficacy of the intervention group.
  
  
  RESULTS
  The patients were randomized, with 100 patients in the intervention group and 106 in the control group. The intervention and control groups were similar with regard to the percentage of women (86% vs. 89.6%), tobacco usage (25% vs. 19.8%), mean age (42.6±13.2 years vs. 46.6±10.9 years), and disease duration (15.3±6.7 months vs. 14.5±6.6 months). The mean outcomes were significantly different between the two groups, and post-hoc pairwise analysis demonstrated significant deterioration in the control group in contrast to improvement in the intervention group at the second, third, fourth, and fifth evaluations. Improvements were often seen as early as the 12-week and 24-week follow-up visits.
  
  
  CONCLUSIONS
  Epidemiology contributes to the evaluation of how well specific therapies or other health interventions prevent or control health problems. The modular program group intervention implemented in this study appears to be a suitable and feasible method to facilitate much more comprehensive management of early RA in socioeconomically challenged communities.
authors.affiliation: Faculty of Nursing, Midwifery and Paramedical, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Yousefi
authors.affiliation: Center for Rheumatic Diseases, Savitribi Phule Pune University, Pune, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Chopra
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas.
authors.forename: Rez
authors.initials: R
authors.lastname: Farrokhseresht
authors.affiliation: Center for Rheumatic Diseases, Savitribi Phule Pune University, Pune, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sarmukaddam
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Fariba Asadi
authors.initials: FA
authors.lastname: Noghabi
authors.affiliation: College of Physiotherapy, Sancheti Institute for Orthopedic and Rehabilitation, Pune, India.
authors.forename: Nilima
authors.initials: N
authors.lastname: Bedekar
authors.affiliation: Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
authors.forename: Abdolhosain
authors.initials: A
authors.lastname: Madani
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care; D016896:Treatment Outcome
keywords: Early rheumatoid arthritis; Epidemiological method; Quality of life