The two-year follow-up of a randomized comparison of in-patient multidisciplinary team care and routine out-patient care for active rheumatoid arthritis

The long-term effects of a period of 11 days of in-patientmultidisciplinary team care were compared with routine out-patient care in80 patients with active rheumatoid arthritis (RA). Endpoint measuresincluded swollen and tender joint counts, the patient's assessment of pain,the patient's and the physician's assessments of disease activity, the ESRand the Health Assessment Questionnaire (HAQ). Two years afterhospitalization, all 39 patients randomized to the in- patient group and 39out of 41 patients randomized to the out-patient group were evaluable. At 2yr, in the in-patient group the improvement according to mean changes frombaseline was greater than that in the out-patient group for all endpointmeasures except for the HAQ score, the differences not reaching statisticalsignificance. Averaged over the time points 2, 52 and 104 weeks, theimprovement was significantly greater in the in-patient group than in theout-patient group, except for the ESR and HAQ score. In conclusion, a shortperiod of in-patient multidisciplinary team care has a beneficial effect ondisease activity over a period of 2 yr and should be considered as a usefultreatment modality in patients with active RA.