Our new model incorporates for the first time the effect of a subjective measure of disease severity and activity on both costs and utility, making it a sensitive tool to estimate the cost-effectiveness of disease-modifying treatments. New data on resource consumption indicate a shift to higher direct costs, particularly in early disease, and lower indirect costs in more advanced disease. The large size of the data sets used in this model reduces the uncertainty and makes estimates very stable.
A 5-yr follow-up of an arthritis education programme is reported. After adjustment for those lost, deceased or moved away, the 5-yr response rate was 75% among intervention subjects and 78% among controls. Individuals who participated in the education programme maintained their increased knowledge in some aspects. The relative difference in pain and disability over 5 yr was greater in the control group. Most individuals were less active at practising exercise after 5 yr. Improvement in performing exercise and joint protection shown at 12-months follow-up did not persist. Additional questions after 5 yr showed that participants in the education programme had significantly more contact with rheumatologists, physiotherapists and occupational therapists. The participants developed an increased internal sense of control of the disease between 12 months and 5 yr. There was also a significant reduction in reported problems with their disease after 12 months, maintained after 5 yr. This may indicate that patient education contributes to the patient's feeling of responsibility for, and ability to cope with, their diseases.
The benefits of patient education for those with chronic arthritis are well documented. Informed patients should practice self care more often, and may show reduced disability from their disease. An important question relates to maintenance of the knowledge and skills acquired in educational programmes. This prospective study evaluated an education programme for people with rheumatoid arthritis (RA) and osteoarthritis (OA). The intervention group participated in a comprehensively planned six session behaviourally based programme. A questionnaire was given to 100 patients and 95 matched but non-random controls before the programme, 1 month later, and at 3 and 12 months. The intervention group demonstrated improvements in knowledge, self-reported health behaviour and disability scores at 12 months, compared to the controls. No differences were reported in symptoms, compliance with therapy, pain perception, and locus of control.
We identified the first two cases of the Finnish new variant of
Chlamydia trachomatis
(F-nvCT) beyond Finland in two clinical urogenital specimens in Örebro County, Sweden. These Aptima Combo 2 assay-negative specimens were Aptima
Chlamydia trachomatis
(CT) assay positive and had the characteristic C1515T mutation in the 23S rRNA gene. From 22 March to 31 May 2019, 1.3% (2/158) of the CT-positive cases in Örebro County were missed because of the F-nvCT. International awareness, investigations and actions are essential.
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