Four year outcomes of a randomised controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis

Hammond, Alison; Freeman, Kaye E

Abstract

Background:
To evaluate the long-term effects of an educational-behavioural joint protection education programme on adherence and health status of people with early rheumatoid arthritis (RA).



Methods:
A four year follow-up of a randomised, controlled, assessor blinded trial was conducted. Outcomes of two interventions (both 8 hours) were compared: a standard arthritis education group, including 2.5 hours of joint protection education based on typical UK practice; and a joint protection arthritis education programme, using educational-behavioural methods.

Results:
65 people with RA attended the joint protection and 62 the standard programmes. Groups at entry were similar in age (51 years; 49 years), disease duration (21 months: 17.5 months) and use of non-steroidal anti-inflammatory drugs and disease modifying drugs. An earlier study has already identified at 1 year, the joint protection programme led to significant improvements in adherence, pain, early morning stiffness, and functional ability (1). In comparison to the standard group at 4 years, the joint protection group continued to have significantly improved: joint protection adherence (p = 0.001); early morning stiffness (p = 0.01); AIMS2 activities of daily living score (p = 0.05). Within group analyses showed the joint protection group had improved tender joint counts (p =0.005), grip strength (p = 0.004), self-efficacy for pain (p = 0.01) and perceived control (p = 0.01). Within group analyses for the standard group showed they had significantly worsened AIMS2: activities of daily living (p = 0.01), upper limb function (p = 0.04), and a trend to worse lower limb function (p = 0.06) scores.

Conclusions:
Significant improvements in joint protection adherence continued at 4 years, although this was less than at one year follow-up. Functional and upper limb ability was maintained in those attending the joint protection programme compared to declining function in the standard education group. At 4 years the functional benefits of joint protection continue.

Citation

Hammond, A., & Freeman, K. E. (2003, April). Four year outcomes of a randomised controlled trial of an educational-behavioural joint protection programme for people with rheumatoid arthritis. Paper presented at The British Society for Rheumatology XX Annual Meeting, A Joint Meeting

• Presentation Conference Type: Conference Paper (unpublished)
• Conference Name: The British Society for Rheumatology XX Annual Meeting, A Joint Meeting
• Start Date: Apr 1, 2003
• End Date: Apr 2, 2003
• Deposit Date: Oct 30, 2023
• Publisher: Oxford University Press