Efficacy of a Modular Lifestyle Intervention Through Occupation for Individuals With Rheumatoid Arthritis: A Randomized Controlled Trial With 6-Month Follow-Up

IMPORTANCE: Rheumatoid arthritis (RA) causes persistent symptoms that limit individuals' ability to engage in meaningful daily occupations. Occupational therapy plays a key role in integrating lifestyle and behavioral strategies into comprehensive RA management. OBJECTIVE: To examine the efficacy of a client-centered, modular lifestyle intervention (LI) on occupational performance and health outcomes of individuals with RA. DESIGN: A randomized controlled trial. SETTING: Rheumatology outpatient clinic of a university hospital. PARTICIPANTS: Forty-five individuals diagnosed with RA were randomly assigned to an LI group (n = 23) or a control group (n = 22). INTERVENTION: The LI group received an eight-session, occupation-based LI; the control group received twice-weekly well-being check phone calls over 4 wk. OUTCOMES AND MEASURES: The primary outcome was the Canadian Occupational Performance Measure (COPM) Performance score. Secondary outcomes included COPM Satisfaction, Disease Activity Score-28, visual analog scale for pain, Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire, and Rheumatoid Arthritis Quality of Life Scale scores. Assessments were conducted at baseline, postintervention, and 6-mo follow-up. RESULTS: Compared with the control group, the LI group demonstrated significantly greater improvements in the primary outcome (COPM Performance) as well as in secondary outcomes including COPM Satisfaction, pain, fatigue, and quality of life. A delayed reduction in disease activity was observed at the 6-mo follow-up. CONCLUSIONS AND RELEVANCE: The LI produced durable improvements in occupational performance and patient-reported outcomes, supporting its integration as a sustainable adjunct to pharmacological care for individuals with RA. Plain-Language Summary: People with rheumatoid arthritis often have difficulty completing daily activities because of pain, fatigue, and limitations in movement. This study explored whether a structured lifestyle program based on occupational therapy principles could help improve these challenges. All participants continued their usual medical treatment throughout the study. In addition, one group received an eight-session lifestyle intervention focused on meaningful daily activities, healthy habits, energy conservation, and participation in social and leisure activities. The control group received their usual medical treatment along with brief well-being check phone calls. Participants who received the lifestyle program showed greater improvements in performing and enjoying daily activities and reported lower fatigue levels than those in the control group. These findings suggest that adding an occupation-based lifestyle program to standard medical care may provide meaningful benefits for people living with rheumatoid arthritis.