Evaluation of a multidisciplinary care model to improve quality of life in rheumatoid arthritis: a randomised controlled trial

Lahiri, Manjari; Cheung, Peter; Dhanasekaran, Preeti; Wong, Su Ren; Yap, Ai; Tan, Daphne S; Chong, Siew Hwa; Tan, Chiew Hwa; Santosa, Amelia; Phan, Phillip H.

doi:10.1007/s11136-021-03029-3

Cited by 11 publications

(8 citation statements)

References 53 publications

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“…38,39 Only four studies reported on participant ethnicity. 35,38,40,41 Patient education. Studies with interventions emphasizing patient education were reported in 16 papers (n = 1,021): 1 high, 42 1 moderate quality 43 (qualitative), and 6 moderate and 8 high risk of bias (quantitative, including an MA thesis 43 ).…”

Section: Resultsmentioning

confidence: 99%

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The Impact of Occupational Therapy on the Self‐Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review

Gavin,

Rossiter,

Fenerty

et al. 2024

ACR Open Rheumatology

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ObjectiveTo determine the impact of occupational therapy (OT) on the self‐management of function, pain, fatigue, and lived experience for people living with rheumatoid arthritis (RA).MethodsFive databases and gray literature were searched up to June 30, 2022. Three reviewers screened titles and abstracts, with two independently extracting and assessing full texts using the Cochrane risk of bias (quantitative) and Critical Appraisal Skills Programme (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE‐ Confidence in Evidence from Reviews of Qualitative research (qualitative) were used to assess the quality of evidence for each intervention type.ResultsOf 39 eligible papers, 29 were quantitative (n = 2,029), 4 qualitative (n = 50), and 6 mixed methods (n = 896). Good evidence supports patient education and behavior change programs for improving pain and function, particularly group sessions of joint protection education, but these do not translate to long‐term improvements for RA (>24 months). Comprehensive OT had mixed evidence (limited to home OT and an arthritis gloves program), whereas limited evidence was available for qualitative insights, splints and assistive devices, and self‐management for fatigue.ConclusionAlthough patient education is promising for self‐managing RA, no strong evidence was found to support OT programs for self‐managing fatigue or patient experience and long‐term effectiveness. More research is required on lived experience, and the long‐term efficacy of self‐management approaches incorporating OT, particularly timing programs to meet the individual's conditional needs (i.e., early or established RA) to build on the few studies to date.

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Section: Resultsmentioning

confidence: 99%

“…Three papers reported from an education behavioral RCT, 33–35 two papers from a workplace RCT, 11,28 two papers from an arthritis gloves trial, 36,37 and one study and report from a group cognitive behavioral therapy (CBT) RCT 38,39 . Only four studies reported on participant ethnicity 35,38,40,41 …”

Section: Resultsmentioning

confidence: 99%

The Impact of Occupational Therapy on the Self‐Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review

Gavin,

Rossiter,

Fenerty

et al. 2024

ACR Open Rheumatology

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“…The mean duration of disease ranged from 1.4 to 17.5 years, with an average duration of 10.9 years. Only 5 studies (42−46) described their applied intervention as being able to adapt to the participants’ needs and preferences, with the remaining studies either having an unclear description (37,47,48), or applying a uniform or standardized intervention.…”

Section: Resultsmentioning

confidence: 99%

“…The agreement between the two trial assessors corresponded to an interrater reliability of κ = 0.48 (95%CI, 0.41 to 0.55) for the title/abstract screening, and κ = 0.93 (95%CI, 0.86 to 1.00) for the full-text assessment. Two of these trials were published as abstracts only (36,37), and three trials were ongoing (38)(39)(40). The corresponding authors of two trials (36,41) were contacted as they presented insufficient data concerning effect, but we received no response.…”

Section: Study Selectionmentioning

confidence: 99%

Biopsychosocial Rehabilitation for Inflammatory Arthritis and Osteoarthritis Patients: A Systematic Review and Meta‐Analysis of Randomized Trials

Pedersen

Thinggaard

Geenen

et al. 2022

Arthritis Care & Research

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To assess the benefits and harms associated with biopsychosocial rehabilitation in patients with inflammatory arthritis (IA) and osteoarthritis (OA). METHODS:We performed a systematic review and meta-analysis. Data were collected through electronic searches of Cochrane CENTRAL, Medline, Embase, PsycINFO, and CINAHL databases up to March 2019. Trials examining the effect of biopsychosocial rehabilitation in adults with IA and/or OA were considered eligible, excluding rehabilitation adjunct to surgery. The primary outcome for benefit was pain, and total withdrawals for harm. RESULTS:Of the 27 trials meeting the eligibility criteria, 22 trials (3,750 participants) reported sufficient data to be included in the quantitative synthesis. For patient reported outcome measures, biopsychosocial rehabilitation was slightly superior to control for pain relief (SMD -0.19 [95%CI, -0.31 to -0.07]), had a small effect on patient global (SMD -0.13 [95%CI, -0.26 to -0.00]), with no apparent effect on health-related quality of life, fatigue, self-reported disability/physical function, mental well-being, and reduction in pain intensity ≥30%. Clinician measured outcomes displayed a small effect on observed disability/physical function (SMD -0.34 [95%CI, -0.57 to -0.10]), a large effect on physician global score (SMD -0.72 [95%CI, -1.18 to -0.26]), and no effect on inflammation. No difference in harms for number of withdrawals, adverse events, or serious adverse events.

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“…This investigation followed a cross-sectional, retrospective study design in which seconardary analysis of a primary data set was conducted. Records were reviewed for clinical data that had already been collected as part of routine clinical care and an existing larger study [31] at the One-Stop Arthritis Clinic (OSAC) at the National University Hospital Rheumatology department in Singapore. The data collected included clinical examination, patient-reported outcomes using face-to-face and self-report questionnaires, and review of medical records as part of standard clinical practice (DSRB Reference: 2022-00037, Research Collaboration Agreement Reference: RITM0450258).…”

Section: Methodsmentioning

confidence: 99%

Disabling foot pain and its impact on daily living among people with Psoriatic Arthritis in Singapore: A cross-sectional observational investigation

Teo,

Chia,

Bowen

et al. 2023

Preprint

Self Cite

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Background Psoriatic Arthritis (PsA)-related foot involvement has been shown to have a profound impact on daily functioning, with most studies having focused on predominantly Caucasian populations. The aim was to describe disabling foot pain (DFP) and its impact on daily living in PsA in Singapore. Methods A cross-sectional, retrospective study was conducted using clinical data collected during a single-visit to a rheumatology clinic in Singapore. Records for adults with physician-diagnosed PsA were reviewed for sociodemographic information, disease characteristics, global disease activityand burden. Foot-specific measures included clinical assessment and the Manchester Foot Pain and Disability Index used to define DFP and evaluate between-group differences. Results Forty-two participants with PsA (83% female, 57% Chinese, 31% Malay, 9.5% Indian, mean (SD) age 54-years (16)) attended the rheumatology clinic over the study-period. The median (IQR) disease duration was 2-years (11) and all were taking current DMARDs. Global disease measures demonstrated mild-to-moderate global disease activity and mild functional impairment, and were significantly higher in those with DFP. Despite 90% reporting to be coping well with their condition, self-care and having emotional support (n=38), this study sample demonstrated high levels of anxiety/depression (29%), sleep disturbance (34%) and fatigue (24%), and a lack of disease- and drug-specific knowledge (64%). Further management was indicated for medication adherence counselling (48%), occupational therapy (43%), physiotherapy (36%) and podiatry (30%). Nearly half had current foot pain with 40% reporting DFP (n=17), which caused significantly greater difficulty walking 3km and with 1-2 household tasks than those without DFP (p<0.05). Rearfoot enthesitis (plantar fasciitis, Achilles enthesitis) was the most common cause of DFP (67%) with pain lasting longer than 1-year. 72% were overweight or obese, with a high proportion not engaging in any cardiovascular exercise (70%). Three of 42 participants had previously seen a podiatrist. Conclusions People with DFP in PsA experience more severe global disease activity, reduced mobility and higher levels of negative impact on their daily lives in Singapore. In the absence of working in a multidisciplinary-team, there is value in comprehensive assessments that have potential to capture a holistic view of personal impact and improve person-centred care in PsA.

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Evaluation of a multidisciplinary care model to improve quality of life in rheumatoid arthritis: a randomised controlled trial

Cited by 11 publications

References 53 publications

The Impact of Occupational Therapy on the Self‐Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review

The Impact of Occupational Therapy on the Self‐Management of Rheumatoid Arthritis: A Mixed Methods Systematic Review

Biopsychosocial Rehabilitation for Inflammatory Arthritis and Osteoarthritis Patients: A Systematic Review and Meta‐Analysis of Randomized Trials

Disabling foot pain and its impact on daily living among people with Psoriatic Arthritis in Singapore: A cross-sectional observational investigation

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