Rheumatoid Arthritis Clinical Trial
Official title:
Medical In-Patient Rehabilitation in Rheumatoid Arthritis: Acceptance and Outcomes in Insurants of Compulsory Health Insurances and Statutory Pension Insurances (VERA)
The randomised controlled trial explores the efficacy of a counselling interview on an multidisciplinary multimodal intervention to ameliorate the somatic, mental and social medical progress of rheumatoid arthritis in gainfully employed insurants of compulsory health insurances and statutory pension insurances . Additionally, the feasibility to recruit a study population via databases of compulsory health insurances is examined.
Rheumatoid arthritis is the most prevalent inflammatory rheumatic disease. Limited
participation of the individual patient accumulates with large amounts of indirect costs for
society: About 40 % of the affected patients have to quit their jobs within the first three
to four years after disease onset. Nevertheless, the German health care system still seems
to lack an adequate supply, particularly in case of medical rehabilitation in early stages
of disease. International clinical trials, reviews amd evidence-based guidelines emphasize
the importance of an early multimodal multidisciplinary team care as in Germany provided by
specialised clinics through three-week in-patient medical rehabilitation programs. The
available study explores the efficacy of a counselling interview on an medical in-patient
rehabilitation in a randomised controlled design. Exclusively, gainfully employed insurants
of compulsory health insurances and statutory pension insurances are included in the study.
Secondary, to avoid the problem of a selection bias caused by recruitment via clinics or
doctors, the RCT tests the possibility to recruit potential participants by data of the
co-operating health insurances on RA-specific diagnoses of work incapacity, hospital
discharge diagnoses, and medical prescriptions within the past 24 months.
Detailed process:
1. Recruitment of a potential study population via health insurance data (defined search
criteria: ICD-10 diagnoses M05/06/13/79 in case of work disability/hospital discharge,
RA-specific medical prescriptions within the past 24 months)
2. screening questionnaire to verify in-/exclusion criteria
3. selection of eligible insurants (RA-criteria of American College of Rheumatology,
clinical expert)
4. baseline measurement (e.g. SF-36, RAQoL, FFbH-P, SPE)
5. external stratified block by block randomization: intervention group (3- week medical
in-patient rehabilitation) vs. control group (usual care)
6. follow-up measurement (12 months after baseline)
7. data transfer of health insurances and pension insurances
Comparison:
Looking at a 12-months follow-up, the intervention group (3-week medical in-patient
rehabilitation) is expected to show significant enhancement in somatic, mental and social
medical parameters concerning rheumatoid arthritis compared to a control group receiving
usual care.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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