The outcome was studied in 100 patients with adult-onset primary ankylosing spondylitis (AS). After a mean disease duration of 16 yr, 51.5% of the patients were employed in full-time work. Cessation of work occurred at a mean disease duration of 15.6 yr, and was significantly associated with female sex, low levels of education, acute anterior uveitis, 'bamboo spine' and the co-existence of non-rheumatic diseases. Functional outcome was studied by analysing activities of daily living, and revealed similar findings in males and females. Most of the loss of function occurred during the first 10 yr of disease, and correlated significantly with the occurrence of peripheral arthritis, spinal X-ray changes of AS and development of 'bamboo spine'. After > 20 yr of disease, > 80% of the patients still complained of daily pain and stiffness, and > 60% reported daily use of drugs.

Objective. To examine possible associations between chronic inflammatory arthritides and pregnancy outcomes with separate analyses of first and subsequent births before and after diagnosis.Methods. Linkage of data from a registry of patients with chronic inflammatory arthritides and the Medical Birth Registry of Norway enabled a comparison of pregnancy outcomes in women with chronic inflammatory arthritides and pregnancy outcomes in reference subjects. Outcomes of first birth and subsequent births before and after diagnosis were analyzed separately. Associations between chronic inflammatory arthritides and the women's health during pregnancy and delivery as well as perinatal outcomes were assessed in logistic regression analyses with adjustments for maternal age at delivery and gestational age.Results Conclusion. Excess risks were related to first birth in women diagnosed as having chronic inflammatory arthritides, including a higher rate of perinatal mortality. A higher caesarean section rate was related to all patient deliveries. Mainly, pregnancy outcomes before diagnosis did not differ from those in reference subjects.

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Aims and objectives. To investigate the long-term effect of a nurse-led hospital-based patient education programme combining group and individual education for patients with chronic inflammatory polyarthritis. Background. Patient education interventions have shown short-term effects, but few studies have investigated whether the effects are sustained for a longer period. Design. Randomised controlled trial. Methods. Patients with rheumatoid arthritis, psoriatic arthritis and unspecified polyarthritis were randomised to the intervention group (n = 71) or a waiting list (n = 70). Primary outcomes were as follows: Global Well-Being and the Arthritis Self-Efficacy Other Symptoms Subscale. Secondary outcomes were as follows: patient activation, physical and psychological health status, patients' educational needs and a Disease Activity Score (DAS28-3). Results. The intervention group had a statistically significant higher global well-being than the controls after 12 months, mean change score 8Á2 (95% CI, 1Á6-14Á8; p-value = 0Á015), but not in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change score 2Á6 (95% CI, À1Á8 to 7Á1; p-value = 0Á245). Within each group, analyses showed a statistically significant improvement in DAS28-3, mean change -0Á3 (95% CI, À0Á5 to À0Á1; p-value = 0Á001), in the intervention group from baseline to 12 months, but not in the controls. The controls had a statistically significant deterioration in the Arthritis SelfEfficacy Other Symptoms Subscale, mean change À5Á0 (95% CI, À8Á6 to À1Á3; p-value = 0Á008), Arthritis Impact Measurement Scales -2 Social, mean change 0Á3 (95% CI, 0Á1-0Á5; p-value = 0Á008), and Hospital Anxiety and Depression Scale total, mean change 1Á4 (95% CI, 0Á3-2Á5; p-value = 0Á013). Conclusion. A combination of group and individual patient education has a long-term effect on patients' global well-being. Relevance to clinical practice. Nurses should consider whether a combination of group and individual patient education for patients with chronic inflammatory polyarthritis is an alternative in their clinical practice. This combination is less timeconsuming for the patients, and it includes the benefit of group learning in addition to focusing on patient's individual educational needs.

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