Effectiveness of the introduction of an International Classification of Functioning, Disability and Health-based rehabilitation tool in multidisciplinary team care in patients with rheumatoid arthritis

Arthritis Rheum. 2007 Mar 15;57(2):240-8. doi: 10.1002/art.22539.

Abstract

Objective: To investigate whether the use of an International Classification of Functioning, Disability and Health (ICF)-based instrument to structure multidisciplinary care improves clinical effectiveness and satisfaction in patients with rheumatoid arthritis (RA) admitted for multidisciplinary team care.

Methods: Consecutive patients with RA admitted to an inpatient or day patient multidisciplinary team care ward were included during a 12-month period before (period I) and after (period II) the introduction of an ICF-based rehabilitation tool (Rehabilitation Activities Profile [RAP]). Patients were assessed at admission, discharge, and 6 weeks thereafter. The primary outcome measure was a patient-oriented measure of functional ability (McMaster Toronto Arthritis Patient Preference Disability Questionnaire [MACTAR]), whereas secondary outcome measures included measures of physical and mental functioning, quality of life, disease activity, and patient satisfaction. Change scores between periods were compared using analysis of covariance.

Results: A total of 80 and 85 patients were included in periods I and II, respectively. Concerning the improvement of the MACTAR score and all other secondary clinical outcome measures, there was no significant difference between the 2 periods. Patient satisfaction with care was slightly higher in period II than in period I, with the differences regarding the total score of a multidimensional satisfaction questionnaire and the domains focusing on individual problems and empathy reaching statistical significance.

Conclusion: The introduction of the RAP did not change clinical effectiveness but had a modest beneficial impact on patient satisfaction with care in patients with RA admitted for multidisciplinary team care.

Publication types

  • Validation Study

MeSH terms

  • Activities of Daily Living / classification*
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid / psychology
  • Arthritis, Rheumatoid / rehabilitation*
  • Cohort Studies
  • Disability Evaluation*
  • Female
  • Health Status
  • Health Status Indicators
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team*
  • Patient Satisfaction
  • Prospective Studies
  • Surveys and Questionnaires / standards*