Background/Purpose:

To study goal achievement among patients with chronic inflammatory arthritis after arthritis rehabilitation performed in multidisciplinary team rehabilitation programs.

Methods:

146 consecutive patients with rheumatoid arthritis (RA) and spondylarthritis (SpA), age 18 years or older, completing arthritis rehabilitation for 5 days or more at 2 rheumatology specialist units were included in this study.  At admission and discharge the patients were evaluated with measures on functioning (HAQ), self efficacy (ASES), psychological health (Hopkins Symptom Checklist – HSCL-25), pain and fatigue (NRS) and on health related quality of life (HRQoL) as captured by the EQ-5D and the SF-36. Comorbidity and social demographics was also reported. The patients, in cooperation with the health professionals, set individual goals for their rehabilitation period. At discharge the patients reported if the goal was achieved completely, partially or not at all.

Non parametric statistical analyses were performed and Chi2 and Kruskal-Wallis analyses were used to study the relationship between goal achievement and baseline and change variables. 

Results:

108/146 patients reported whether goals were achieved or not, and were included in further analyses. 76% were females and 55% had RA. At baseline median age was 54 years (IQR 17), median HAQ 0.88 (IQR 0.88), median HRQoL as captured by the EQ-5D 0.62 (IQR 0.57) and median psychological wellbeing according to HSCL-25 1.62 (IQR 0.68). The patients reported median fatigue 6.0 (IQR 4.0) and median pain 5.0 (IQR 3.0) when entering the rehabilitation program that lasted for median 18 days (IQR 2).

58/108 patients (54%) rated their goal to be completely achieved, 40 patients (37%) reported partial goal achievement while 10 (9%) patients had not achieved their goal. Positive reporting of having followed the recommendations (compliance) during the rehabilitation period was obtained from 100 (93%) of the patients.

Change after intervention and compliance did not affect reports of goal achievement after rehabilitation. Females reported goal achievement more often than men did (p=0.019). Those not achieving their goals reported less psychological wellbeing (HSCL-25, p=0.011) at admission together with reports of worse pain (SF-36bp, p=0.011). 

Conclusion: 54% of the included patients reported complete goal achievement after arthritis team rehabilitation. Neither change after intervention nor compliance affected patients’ reports of goal achievement. Female patients were more prone to achieve their goals while patients experiencing less psychological wellbeing or more pain at baseline were less prone to report goal achievement.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/who-will-achieve-individually-set-goals-after-arthritis-team-rehabilitation/