Background/Purpose: Functional limitation is common in adults with rheumatoid arthritis (RA). Rehabilitation services, like physical therapy (PT) and occupational therapy (OT), are effective in improving function; however little is known regarding rehabilitation utilization patterns in adults with RA. The purpose of this study was to evaluate the association of baseline factors (demographic and clinical characteristics) with rehabilitation dose (number of subsequent PT/OT visits) among adults with RA who received PT/OT services.  We hypothesize that worse disease activity and functional status will associate with more PT/OT visits.

Methods: We used data from the FORWARD registry. Participants in the FORWARD registry completed questionnaires every six months regarding health care utilization and patient reported outcomes. The analytic sample includes adults with doctor-diagnosed RA who reported new PT/OT utilization after at least 1 year with no PT/OT utilization. We excluded those with total joint replacement or skilled nursing/inpatient rehab within one year prior to first report of PT/OT or during the first episode of care. The baseline factors of interest were extracted from the preceding study visit 6 months before the study visit with reported PT/OT utilization. These baseline factors included demographic and clinical characteristics: age, sex, body mass index, race, disease duration, disease activity (Patient Activity Scale), functional status (Health Assessment Questionnaire Disability Index), pain severity (Visual Analog Scale), and fatigue severity (Visual Analog Scale). The study outcome was rehabilitation dose (number of PT/OT visits) in the past 6 months. The number of PT/OT visits was self-reported as one of five categories: 1-2, 3-4, 5-6, 7-8, or >8 visits. We examined the association of the baseline factors with rehabilitation dose (more PT/OT visits) using logistic regression (proportional odds model), and mutually adjusted for the other baseline factors.

Results: In the FORWARD registry, 979 adults received rehabilitation after a minimum one-year period with no reported rehabilitation (Table 1). Worse functional status, greater disease severity, and higher pain severity were associated with a higher dose of rehabilitation in unadjusted models, however the associations were attenuated in adjusted models (Table 2). Women had higher odds of more rehabilitation in unadjusted and adjusted models. Other demographics and clinical characteristics were not associated with rehabilitation dose.

Conclusion: Rehabilitation dose was higher among women compared to men. Other demographic and clinical characteristics were not associated with rehabilitation dose. Further research is needed to understand factors associated with rehabilitation dose in adults with RA.

Table 1. Sample demographics and characteristics

Table 2. Association of demographic and baseline clinical characteristics with rehabilitation dose

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/baseline-factors-are-not-associated-with-rehabilitation-dose-over-six-months-among-adults-with-ra/