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Abstract
Background Chronic musculoskeletal (MSK) conditions impair health and function. Clinical guidelines recommend a Multidisciplinary Team (MDT) approach for the optimum management of chronic MSK conditions. The efficacy of inpatient MDT care on the health and disease status of people with chronic musculoskeletal conditions is unclear.
Objectives To evaluate the efficacy of a MDT inpatient service for people with chronic musculoskeletal conditions.
Methods Patients with Rheumatoid Arthritis (RA), Osteoarthritis (OA), Low Back Pain (LBP) and Chronic Widespread Pain (CWP) admitted for inpatient MDT rehabiiltation to a rheumatology unit in a UK hopsital completed the Multi-Dimensional Health Assessment Questionnaire (MDHAQ)1, visual analogue scale (VAS 0-10cm) for pain and for global wellbeing on admission and discharge. The rehabilitation programme consisted of a personalised regime of exercise including hydrotherapy and MDT input. RAPID3 scores (Routine Assessment of Patient Index Data)1 were calculated then analysed using descriptive statistics and paired sample t-tests. A 20% improvement in RAPID3 was considered a clinically significant change.
Results 183 patients (Mean Age 62 [Range 18-97], 145 females) were admittted (median length of stay 10 days [Range 5-15]) between January 2010 and September 2011. Overall there was a 28% improvement in RAPID3 (mean difference 5.01 [4.3, 5.8] (95%CI), P<0.05) on discharge. Clinically signifiicant changes were noted in people with RA (32%), OA (35%), CWP (25%) and LBP (22%) (all P<0.05, Table).
Conclusions This inpatient MDT rehabilitation programme improved self reported disease status and function in patients with RA, OA, LBP and CWP. The long term efficacy and cost effectiveness of inpatient MDT care requires further investigation.
References
Pincus T et al. Towards a multidimentional health assessment questionnaire (MDHAQ). Assessment of advanced activities of daily living and psychological status in the patient-friendly health assessment questionnaire format. Arthritis and Rheumatism 1999; 42(10): 2220-2230.
Acknowledgements The authors would like to thank the patients and clinicians at Bognor Regis War Memorial Hospital.
Disclosure of Interest None Declared