A Randomized Clinical Trial of in-Patient Multidisciplinary Treatment Versus Routine Out-Patient Care in Active Rheumatoid Arthritis

The aim of the present study was to compare the effects of in-patient multidisciplinary treatment with standard out-patient care in patients with active rheumatoid arthritis (RA). Eighty patients with active RA were randomized to receive 11 days of in-patient multidisciplinary treatment followed by standard out-patient care (n = 39), or to standard out-patient care only (n = 41). Patients were assessed at baseline, and after 2, 4, 12 and 52 weeks. In the in-patients, the improvement in variables of disease activity (weeks 2 and 4) and emotional status (weeks 4 and 12) was greater when compared with the out-patients (P < 0.05). The improvement in laboratory and functional measures did not differ between the groups. In the in-patient group, the percentage of patients responding to the American College of Rheumatology criteria for improvement was significantly greater at any time point during follow-up than in the out-patient group. A short period of in-patient multidisciplinary treatment for active RA has a direct beneficial effect on disease activity and emotional status with the favourable effect on disease activity remaining after 52 weeks.