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Which patients improve the most after arthritis rehabilitation? A study of predictors in patients with inflamatory arthritis in northern Europe, the STAR-ETIC collaboration
Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
Department of Rheumatology, Department of Physical Therapy, Leiden University Medical Center, Leiden, Netherlands & National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
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2014 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, Vol. 46, no 3, 250-257 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investigated.

DESIGN: Multicentre prospective observational study in 4 European countries.

METHODS: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and the Short Form 36 Health Survey (SF-36) in 731 patients who underwent multidisciplinary rehabilitation. Potential predictors were physical functioning (Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)), pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity, education, clinical setting and change of medication during rehabilitation. Analysis of covariance (ANCOVA) was used to assess for potential predictors and interactions. The minimal important differences for HRQoL were analysed.

RESULTS: Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b 0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b 0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication during rehabilitation (b 0.08, p = 0.013) was associated with greater improvement in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal important differences were noted in 46% (EQ-5D) and 23-47% (SF-36 subscales) of the patients.

CONCLUSION: Patients with more severe symptoms experienced the largest gain in HRQoL post-intervention. The results of this study are of value for selecting the right patients for rheumatological team rehabilitation.

Place, publisher, year, edition, pages
Uppsala, Sweden: Foundation of Rehabilitation Information , 2014. Vol. 46, no 3, 250-257 p.
Keyword [en]
Ankylosing spondylitis, Quality of life, Rehabilitation, Rheumatoid arthritis
National Category
Medical and Health Sciences
URN: urn:nbn:se:hh:diva-25223DOI: 10.2340/16501977-1267ISI: 000332903400009PubMedID: 24448626ScopusID: 2-s2.0-84894665378OAI: diva2:714992

The European League Against Rheumatism (EULAR) has financially supported the STAR-ETIC by EULAR grant CLI022. This work was supported by Lund University Faculty of Medicine and the Capio’s Research Foundation. The Norwegian arm of this study, the SPOR project, was financed by Extra-stiftelsen Helse og Rehabilitering in Norway.

Available from: 2014-04-30 Created: 2014-04-30 Last updated: 2014-11-10Bibliographically approved

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