title: Involvement of the multidisciplinary team and outcomes in inpatient rehabilitation among patients with inflammatory rheumatic disease.
abstract: BACKGROUND
  The last decades have for patients with inflammatory rheumatic diseases seen a shift towards more physically active rehabilitation programs, often provided as out-patients with less use of inpatient facilities. There is little research on which effect the multidisciplinary team has on health outcomes for patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and connective tissue disease. This study examined patient reported outcomes for patients with inflammatory rheumatic diseases receiving rehabilitation care as inpatients in departments of rheumatology, and studied how number of consultations with the multidisciplinary team affected these clinical outcomes.
  
  
  METHODS
  Patients with inflammatory rheumatic diseases were included in a multi-center prospective observational study if rehabilitation was considered a focus during an inpatient stay at four departments of rheumatology. At admission, discharge, and after 3 and 6 months, 317 patients were assessed with patients reported outcomes (PRO) including health assessment questionnaire (HAQ), short-form 36 (SF-36), pain, fatigue, patient global assessment of disease activity, self-efficacy scales, rheumatoid arthritis disease activity index (RADAI), and SF-6D utility. Patients stated consultations with the multidisciplinary team.
  
  
  RESULTS
  Improvements were short-lived, and at 6 months follow-up period only mental health, pain and utility remained improved with small effect sizes. Extensive involvement of health professionals was not associated with improved outcomes.
  
  
  CONCLUSIONS
  Patients with inflammatory rheumatic disease receiving inpatient multidisciplinary rehabilitation had small and mainly short-term improvements in most PROs. High use of the multidisciplinary team did not enhance or preserve rehabilitation outcomes in inflammatory rheumatic conditions when admitted as inpatients.
authors.affiliation: Department of Rheumatology, From the National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. tillmann.uhlig@medisin.uio.no.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway. tillmann.uhlig@medisin.uio.no.
authors.forename: Till
authors.initials: T
authors.lastname: Uhlig
authors.affiliation: Martina Hansens Hospital, Bærum, Norway. olav.bjoerneboe@mhh.no.
authors.forename: Olav
authors.initials: O
authors.lastname: Bjørneboe
authors.affiliation: Rheumatism Hospital, Lillehammmer, Norway. frode@revmatismesykehuset.no.
authors.forename: Frode
authors.initials: F
authors.lastname: Krøll
authors.affiliation: Østfold Hospital, Sarpsborg, Norway. oypalm@gmail.com.
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Palm
authors.affiliation: Department of Rheumatology, From the National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. inge.christoffer.olsen@gmail.com.
authors.forename: Inge Christoffer
authors.initials: IC
authors.lastname: Olsen
authors.affiliation: Oslo and Akershus University College of Applied Sciences, Oslo, Norway. margreth.grotle@hioa.no.|Oslo University Hospital, FORMI, Oslo, Norway. margreth.grotle@hioa.no.
authors.forename: Margreth
authors.initials: M
authors.lastname: Grotle
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000534:rehabilitation; D007400:Interprofessional Relations; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000534:rehabilitation*; D016896:Treatment Outcome