One hundred and thirty-two patients discharged from a rheumatology unit were randomly allocated to general practitioner care, attendance at hospital outpatient clinics, or follow-up by a senior occupational therapist attached to the hospital treatment team. At the end of 1 and 2 years a number of clinical and functional tests were applied, and information was gathered about the provision and use of aids and the provision of domestic support. In addition the standard of overall care was judged by an independent assessor. Although no significant intergroup differences in disease activity or function emerged, it is clear that patients prefer continuing contact with the hospital team, and this may lead to differences appearing in the future. The financial advantages of therapist follow-up are discussed.