Key result
Remote physiotherapist counselling paired with self-monitoring tools improved self-management ability in rheumatoid arthritis patients (adjusted coefficient 5.3; 95% CI 2.0-8.7; P≤0.001).
Why the study?
To assess whether a remote physiotherapist counselling intervention using self-monitoring tools improves self-management ability, physical activity participation, and health outcomes in people with rheumatoid arthritis.
Does a remote physiotherapist counselling intervention with self-monitoring tools improve self-management ability in patients with rheumatoid arthritis?
RCT (n=131)
randomly assigned
Does a remote physiotherapist counselling intervention with self-monitoring tools improve self-management ability in patients with rheumatoid arthritis?
Mean Difference: 5.3 (95% CI 2–8.7)
Absolute Event Rate: 4.6% vs -1.6%
p-value: p=≤ 0.001
Remote counselling paired with self-monitoring tools significantly improves self-management ability and symptom management in patients with rheumatoid arthritis.
Remote PT counselling with self-monitoring tools improves RA self-management; supports routine integration and larger trials on adherence and outcomes.
OBJECTIVES: To assess a remote physiotherapist (PT) counselling intervention using self-monitoring tools for improving self-management ability, physical activity participation and health outcomes in people with rheumatoid arthritis (RA). METHODS: Eligible participants were randomly assigned to receive group education, a Fitbit®, a self-monitoring app, and PT counselling phone calls (Immediate Group). The Delayed Group received a monthly e-newsletter until week 26, and then the intervention. The primary outcome was Patient Activation Measure (PAM-13). Participants were assessed at baseline, 27 weeks (the primary end point) and 53 weeks. Secondary outcomes included disease activity, pain, fatigue, depression, sitting/walking habits, daily physical activity time and daily awake sedentary time. Generalized Linear Mixed-effect Models (GLMMs) were used to assess the effect of the intervention on the change of each outcome measure from the initiation to 27 weeks after the intervention. RESULTS: Analysis included 131 participants (91.6% women; 80.2% completed during the COVID-19 pandemic). The mean change of PAM-13 at 27 weeks was 4.6 (Standard Deviation [SD] = 14.7) in the Immediate Group vs -1.6 (SD = 12.5) in the Delayed Group. The mean change in Delayed Group at 53 weeks (after the 26-week intervention) was 3.6 (SD = 14.6). Overall, the intervention improved PAM-13 at 27 weeks post-intervention from the GLMM analysis (adjusted coefficient: 5.3; 95% CI: 2.0, 8.7; P ≤ 0.001). Favourable intervention effects were also found in disease activity, fatigue, depression and self-reported walking habit. CONCLUSION: Remote counselling paired with self-monitoring tools improved self-management ability in people with RA. Findings of secondary outcomes indicate that the intervention had a positive effect on symptom management.
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Li et al. (2023) conducted an RCT in rheumatoid arthritis (n=131). Remote physiotherapist counselling and self-monitoring tools vs. Monthly e-newsletter (delayed intervention) was evaluated on Change in Patient Activation Measure (PAM-13) at 27 weeks (adjusted coefficient 5.3, 95% CI 2.0, 8.7, p=≤ 0.001). Remote physiotherapist counselling paired with self-monitoring tools improved self-management ability in rheumatoid arthritis patients (adjusted coefficient 5.3; 95% CI 2.0-8.7; P≤0.001).
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