Functional disability in patients with rheumatoid arthritis admitted for multidisciplinary rehabilitation from 1992 to 2009.

OBJECTIVE Advances in pharmacological care for RA have in general reduced functional disability. However, subgroups of patients may need treatment by a multidisciplinary team. This study aimed to describe the levels of functional ability and outcomes of patients with RA admitted for multidisciplinary rehabilitation in the past 20 years. METHODS Data from three observational studies including four cohorts (1, 1992; 2a, 2001; 2b, 2003 and 3, 2008) on outcomes of multidisciplinary rehabilitation for RA patients conducted in one Dutch rheumatology clinic were used. Baseline and change scores of the HAQ were compared using a one-way analysis of variance with post hoc multiple comparisons (Bonferroni correction). RESULTS The mean HAQ scores were 1.94 (s.d. 0.74) for cohort 1, 1.40 (0.74) and 1.39 (0.66) for cohorts 2a and 2b, respectively, and 1.49 (0.59) for cohort 3, with the difference between cohort 1 on the one side and cohorts 2a/2b and 3 on the other side being statistically significant (P < 0.01). The mean changes in HAQ score between admission and discharge were 0.24 (s.d. 0.50) for cohort 1, 0.17 (0.49) for cohort 2a, 0.15 (0.37) for cohort 2b and 0.25 (0.46) for cohort 3. CONCLUSION The level of functional disability of RA patients admitted for multidisciplinary rehabilitation decreased between 1992 and 2001. The magnitude of improvement in functional ability during admission was in the same range in all three periods. These results suggest that in the era of MTX and biologics there are patients with RA who have considerable disability and benefit from multidisciplinary rehabilitation.