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The efficacy of motivational counselling and SMS reminders on daily sitting time in patients with rheumatoid arthritis: a randomised controlled trial
  1. Tanja Thomsen1,
  2. Mette Aadahl2,3,
  3. Nina Beyer4,5,
  4. Merete Lund Hetland1,5,6,
  5. Katrine Løppenthin1,
  6. Julie Midtgaard3,7,
  7. Robin Christensen8,
  8. Mikkel Østergaard1,5,
  9. Poul Jørgen Jennum5,9,
  10. Bente Appel Esbensen1,5
  1. 1 Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Glostrup, Denmark
  2. 2 Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup
  3. 3 Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
  4. 4 Musculoskeletal Rehabilitation Research Unit, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark
  5. 5 Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
  6. 6 The DANBIO Registry, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet - Glostrup, Glostrup, Denmark
  7. 7 University Hospitals Centre for Health Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
  8. 8 Musculoskeletal Statistics Unit, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
  9. 9 Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Dr Bente Appel Esbensen, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Ndr. Ringvej 57, DK-2600 Glostrup, Denmark; bente.appel.esbensen{at}


Objectives The aim of this report is to investigate the efficacy of an individually tailored, theory-based behavioural intervention for reducing daily sitting time, pain and fatigue, as well as improving health-related quality of life, general self-efficacy, physical function and cardiometabolic biomarkers in patients with rheumatoid arthritis (RA).

Methods In this randomised controlled trial 150 patients with RA were randomised to an intervention or a no-intervention control group. The intervention group received three individual motivational counselling sessions and short message service or text messages aimed at reduction of sedentary behaviour during the 16-week intervention period. Primary outcome was change in daily sitting time measured objectively by ActivPAL. Secondary outcomes included change in pain, fatigue, physical function, general self-efficacy, quality of life, blood pressure, blood lipids, haemoglobin A1c, body weight, body mass index, waist circumference and waist–hip ratio.

Results 75 patients were allocated to each group. Mean reduction in daily sitting time was −1.61 hours/day in the intervention versus 0.59 hours/day increase in the control group between-group difference −2.20 (95% CI −2.72 to −1.69; p<0.0001) hours/day in favour of the intervention group. Most of the secondary outcomes were also in favour of the intervention.

Conclusion An individually tailored, behavioural intervention reduced daily sitting time in patients with RA and improved patient-reported outcomes and cholesterol levels.

Trial registration number NCT01969604; Results.

  • multidisciplinary team-care
  • rheumatoid Arthritis
  • rehabilitation
  • cardiovascular Disease
  • patient perspective

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  • Contributors BAE, JM, MA, NB, MLH, KL, MØ, PJJ and TT designed and planned the trial in collaboration with the trial steering committee. BAE, KL and TT obtained funding. TT managed the day-to-day running of the trial. RC designed the statistical analysis plan and carried out the data analyses in collaboration with TT. MA advised on the analyses and interpretations of ActivPAL data. All authors had full access to the data and take responsibility for the integrity of the data and for the accuracy of the data analysis. Additionally, all authors contributed to the interpretation of the results and reviewed and approved the final manuscript. TT drafted this article and is the guarantor.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Danish Data Protection Agency (711-1-08) and the Ethics Committee of the Capital Region of Denmark (H-2-2012-112).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement BAE is willing to examine all requests for the full dataset after a period of 5 years from the date of this publication. The trial steering committee will be involved in the case of query about access to data. Participants did not give consent for data sharing but the presented data are anonymised and risk of identification is low.

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